Poor Outcomes after Whole Brain Radiotherapy in Patients with Brain Metastases: Results from an International Multicentre Cohort Study

Windsor, Apsara; Koh, Eng‐Siew; Allen, S.; Gabriel, Gabriel; Yeo, Anthony E. T.; Allison, Roger; Linden, Y.M. van der; Bartoň, Michael

doi:10.1016/j.clon.2013.07.002

Cited by 22 publications

(18 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study breast and lung cancer were the most common primary sites, too. Wolf et al (2013), Windsor (Windsor et al, 2013) et al andSaha et al (2013) in the US, Australia and India respectively showed that lung cancer is the most common primary site. This discrepancy maybe due to the fact that breast cancer is more prevalent in our country and in our province, too.…”

Section: Discussionmentioning

confidence: 99%

Survival of Brain Metastatic Patients in Yazd, Iran

Akhavan¹,

Binesh²,

Heidari³

2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Survival of Brain Metastatic Patients in Yazd, Iran

Akhavan¹,

Binesh²,

Heidari³

2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

“…Higher BBB pass rate and targeted accumulation of intracranial metastasis are two important properties of Erlotinib in NSCLC, therefore, the combined function of treating brain metastasis and strengthening radiosensitivity of Erlotinib is the theoretical basis of EGFR-TKI concomitant with whole brain radiotherapy (Windsor et al, 2013). Zhang et al, explored the clinical effect and tolerance of 150 mg/d Erlotinib concomitant with 40Gy/20Fx whole brain radiotherapy for 12 NSCLC patients with multiple brain metastasis, indicating some satisfied achievements that total RR, CR, PR, medium PFS, medium OS were 100%, 66.7%, 33.3%, 8 months and 10 months respectively, with 3 rash in I stage and 1 mild diarrhea (Zhang et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Clinical Observation of Whole Brain Radiotherapy Concomitant with Targeted Therapy for Brain Metastasis in Non-small Cell Lung Cancer Patients with Chemotherapy Failure

Cai¹,

Wang²,

Liu³

2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.Keywords: Non-small cell lung cancer -brain metastasis -whole brain radiotherapy -targeted therapy -clinical effect

show abstract

“…Proponents say that WBRT improves palliation by prolonging intracerebral control [4]. Opponents say that WBRT does not increase survival, may cause neurocognitive problems and may not prevent intracerebral progression [5,6]. A randomised controlled trial (RCT) is needed to resolve this controversy.…”

Section: Introductionmentioning

confidence: 99%

Accrual to a randomised trial of adjuvant whole brain radiotherapy for treatment of melanoma brain metastases is feasible

et al. 2014

View full text Add to dashboard Cite

BackgroundBrain metastases (BMs) are common in melanoma patients. Adjuvant whole brain radiotherapy (WBRT) following local treatment of intracranial melanoma metastases with neurosurgery and/or stereotactic radiosurgery is controversial. A randomised trial is needed. However, accrual to WBRT trials has been problematic. A pilot study by Australia and New Zealand Melanoma Trials Group (ANZMTG) was conducted to see if accrual was feasible.MethodsSites canvassed for interest included those who treat melanoma patients, had a proven accrual in previous melanoma trials and who had the relevant infrastructure support. Feasibility forecasts from interested sites were sought. These were compared to the patient numbers documented in the research contracts. A target accrual of 60 patients in 2 years was set. Funding was sought for the pilot study. Basic demographics of the pilot study cohort were collected.ResultsThe first centre opened December 2008; the first patient was randomised in April 2009. The pilot accruing period concluded in September, 2011. In 30 months, 54 patients from 10 of a total of 17 activated sites in Australia (39, 72%) and in Norway (15, 28%) had been accrued. Feasibility forecasts predicted 133 trial eligible patients per year (including 108 Australian + 25 International patients). Site estimates generally overestimated accrual with 4 of 17 active sites estimating within 50% of target numbers. Sites with patient estimates calculated from records were more accurate than those estimated from memory. The overall recruitment target was lower in the research contracts when compared to the feasibility evaluation. Basic demographics of the pilot study revealed 62% of patients were males; 58% had a single metastasis, 28% had two and 14% had three metastases. 12-month overall survival was 50%.ConclusionsDespite only 54 patients and not the full 60 patient target being accrued in two years the Trial Management Committee and Data Safely Monitoring Committee approved the continuation of the pilot study to the main trial. On the basis of this successful pilot study, funding was achieved for the full study. 143 patients of a target of 200 have been randomised by June 2014.

show abstract

Poor Outcomes after Whole Brain Radiotherapy in Patients with Brain Metastases: Results from an International Multicentre Cohort Study

Cited by 22 publications

References 26 publications

Survival of Brain Metastatic Patients in Yazd, Iran

Survival of Brain Metastatic Patients in Yazd, Iran

Clinical Observation of Whole Brain Radiotherapy Concomitant with Targeted Therapy for Brain Metastasis in Non-small Cell Lung Cancer Patients with Chemotherapy Failure

Accrual to a randomised trial of adjuvant whole brain radiotherapy for treatment of melanoma brain metastases is feasible

Contact Info

Product

Resources

About