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Patient outcomes of whole brain radiotherapy for brain metastases versus leptomeningeal metastases: A retrospective study
Author(s) -
Sakaguchi M.,
Maebayashi T.,
Aizawa T.,
Ishibashi N.,
Saito T.
Publication year - 2017
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12597
Subject(s) - medicine , radiation therapy , multivariate analysis , whole brain radiotherapy , univariate analysis , brain metastasis , retrospective cohort study , asymptomatic , oncology , recursive partitioning , chemotherapy , performance status , medical record , radiology , metastasis , cancer
Aim Important factors typically associated with prognosis in brain metastases include Karnofsky performance status (KPS), extracranial or cerebellar localization and combination chemotherapy. However, few studies investigated the prognostic role of leptomeningeal metastases (LM) following whole brain radiotherapy (WBRT). On the basis of our experience suggesting better survival of asymptomatic patients with LM than those with brain metastases, we herein evaluated LM as a prognostic factor after WBRT. Methods Medical records of 206 patients (median age, 65 years) who received WBRT in 2007–2015 were retrospectively reviewed. The two most common cancers were of lung, breast origin in 78.5%, 10%, patients, respectively. Patients received parallel‐opposed WBRT, with a dose of 20–40 Gy. Additional doses of 9–12 Gy were used in patients who were operated on or had single metastases. Overall survival (OS) was determined, and clinical parameters including age, KPS, symptoms, radiation dose, dose per fraction, type of metastasis, extracranial metastases, primary status and surgery plus WBRT were assessed as prognostic factors. Results The median survival was 6 months (range, 1–100), and 1‐ and 2‐year survival rates were 28% and 17%, respectively. In univariate analysis, improved survival was associated with KPS of ≥70, absence of symptoms, radiation dose of ≥37.5 Gy, favorable primary lesion, LM, and surgery plus WBRT. Multivariate analysis revealed that these factors with the exception of radiation dose was significant prognostic factors for OS. Conclusion We found that LM were independent prognostic factors for good clinical outcomes.