がんの科学と治療

Outcomes Following Re-irradiation for Symptomatic Brain Metastasis

Abstract

Ji Hoon Choi

We retrospectively analyzed outcomes of patients who underwent reirradiation for brain metastasis. We analyzed the records of 23 patients with brain metastasis who were initially treated with palliative brain radiotherapy (RT) and were retreated with a second course of brain RT between June 2008 and December 2012. WBRT, 3DCRT, and SRS were used for brain metastasis. The median dose of the first course of WBRT was 30 Gy (range, 23.4-30 Gy). The dose of the first course of 3DCRT for the lesion was 30 Gy in 3 Gy per fraction. The median dose of the first course of SRS was 16 Gy in one fraction (range, 12-24 Gy). The median dose of the second course of WBRT was 27.5 Gy (range, 12-30 Gy). The median dose of the second course of 3DCRT for the lesion was 30 Gy (range, 25-30 Gy). The dose of the second course of SRS was 16 Gy in one fraction. The second course of WBRT was administered on the basis of radiographically proven disease progression with clinical symptoms. With a median follow-up of 25 months, the overall symptom resolution rate was 47.8%. The rate of palliative efficacy was 82.6% including patients with stable disease. The median survival time after initiation of reirradiation was 3.2 months. The median Karnofsky performance status (KPS) value prior to reirradiation was 30, and the median KPS value following reirradiation was 60. Reirradiation of brain metastasis is feasible and effective in select patients with performance status of KPS ≥ 60 (Eastern Cooperative Oncology Group (ECOG) 0-2) prior to reirradiation.