Evaluation of survival time and assessment of prognostic factors in patients with brain metastases treated with different radiation schedules
Keywords:
Brain metastases, Median survival time, Prognosis Factors, Radiation dose, whole brain RadiotherapyAbstract
Background:Whole brain radiotherapy (WBRT) is one of treatment modalities for newly diagnosed brain metastases from various primary malignancies. Several prognostic factors associated with survival time include patient’s factors, patient’s disease and treatment factors such as radiation technique and radiation dose.
Objective: To evaluate survival time and to assess factors associated with survival outcome between different WBRT schedules in patients with brain metastases.
Materials and Methods: Brain metastatic patients who underwent 2D-WBRT at Sawanpracharak Hospital from December 2016 to October 2018 were retrospectively analyzed. The schedule of radiation dose were 30 Gy in 10 fractions and 20 Gy in 5 fractions.
Results: A total of 41 patients completed course of radiation. 2D-WBRT 30 Gy in 10 fractions were prescribed in 12 patients (29.26 %) while 20 Gy in 5 fractions were given in 29 patients (70.74 %). Median overall survival was 3.0 months, 1 month vs 4 months in 30 Gy in 10 fractions group and 20 Gy in 5 fractions group, respectively (HR 0.60, 95% CI 0.29-1.25, p = 0.17). Univariate analysis showed no survival difference in each prognostic group as followings: age <65 or ≥65 years (HR 1.04, 95% CI 0.29-2.05, p = 0.91), gender female or male (HR 0.60, 95% CI 0.30-1.21, p = 1.60), Karnofsky Performance Score<70or ≥70(HR 0.86, 95% CI 0.42-1.78, p = 0.69),extracranial disease (HR 1.20, 95% CI 0.60-2.40, p = 0.61), number of brain metastases (HR 0.86, 95% CI 0.42-1.76, p = 0.62).
Conclusion:Survival time in patients with brain metastases was not significantly correlated with patient’s factor, disease factors and treatment factors.The schedule of radiation dose had no significant impact on survival time.
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