कैंसर विज्ञान एवं चिकित्सा

Effects of Radiotherapy Technique and Doses on Lung Cancer Patients with Brain Metastases

Abstract

Li Li, Yuan Lanhui, Li Jingyun, Wang Xuefeng, Zhang Xi, Qie Shuai, Zhang Xin, Peng Yu, Zhang Lina, Chen Minghong and Shi Hongyun

The aim of this study was to investigate the effects of FSRT and conventional radiotherapy with or without WBRT on OS and short-term outcome of lung cancer patients with brain metastases. 92 patients were involved the study. All the brain MR images were fusioned under the Pinnacle system, then they received local conventional radiotherapy (1.8- 2.0 Gy/F) or FSRT (2.5-4 Gy/F), with or without WBRT, according to the size and number of brain lesions. The OS of all patients was 2 to 33 months with the median survival 15 months. GPA (P=0.050), pathological type (P=0.012), oral targeted drugs (P=0.016), number of BM (P=0.002), radiotherapy technique (P=0.001), radiotherapy dose (P=0.031) and short-term outcome (P=0.002) were the influencing factors of OS. And local radiotherapy was better than local + WBRT than WBRT (P=0.001), FSRT significantly better than conventional radiotherapy (P=0.001). Hierarchical analysis displayed that local radiotherapy was better than local + WBRT than WBRT for those who hadn’t received targeted therapy (P=0.001). For SCLC, local + WBRT was better than WBRT (P=0.003) and for NSCLC FSRT was better than conventional radiotherapy (P=0.024. For patients with lower GPA (≤ 1.5), local radiotherapy was better than local + WBRT than WBRT (P=0.033). The CR rate of the whole group was 6.5%, with PR rate 78.3%. Logistic regression showed that FSRT was more likely to have CR and PR probability (P=0.009). For lung cancer patients with brain metastases, FSRT was superior to conventional radiotherapy, which could improve short-term outcome and extend OS. Local radiotherapy was better than local + WBRT than WBRT.