[en] To investigate whether whole brain irradiation might be replaced by focalized irradiation after resection of a single brain metastasis in patients where extracranial tumor control is deemed to be obtained.
Patients and methods: Twelve patients were introduced in a phase I/II prospective study of conformal postoperative external irradiation after resection of a solitary brain metastasis. The radiation treatment consisted of 50.4 Gy (1.8 Gy per fraction, five fractions per week). The planning target volume consisted of the tumor bed and a 2 cm safety margin. All treatments were optimized with head immobilization, dedicated tomodensitometry and computer assisted three-dimensional treatment planning.
Results: The median survival was 7.2 months (range 2.4–50.4 months). Eleven of the 12 patients died. Eight of the 12 patients presented intracranial recurrence and seven died as a consequence of intracranial tumor progression.
Conclusions: Focalized external irradiation cannot serve as a reasonable alternative to whole brain radiotherapy (WBRT) even for patients with apparently one single resected brain metastasis. The dogma of ‘one metastasis=multiple metastases' seems to be confirmed.
Disciplines :
Oncology Hematology
Author, co-author :
Coucke, Philippe ; Centre Hospitalier Universitaire Vaudois > Radiation Oncology
Zouhair, Abderrahim; Centre Hospitalier Universitaire Vaudois > Radiation Oncology
Ozsahin, Mahmut; Centre Hospitalier Universitaire Vaudois > Radiation Oncology
De Tribolet, Nicoles; Centre Hospitalier Universitaire Vaudois > Neurosurgery
Mirimanoff, René; Centre Hospitalier Universitaire Vaudois > Radiation Oncology
Language :
English
Title :
Focalized external radiotherapy for resected solitary brain metastasis: does the dogma stand?
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