Title: A Comparative Study of two Fractionations Schedule of Palliative Radiation Therapy in Metastatic Brain Tumour
Authors: Dr Manju Lata Yadav, Dr Shankar L Jakhar, Dr Neeti Sharma, Dr Kunal Jain, Dr H. S Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.93
Abstract
Background: Management of Brain Metastases is a significant health care problem and is most common intracranial malignancy in adults. Whole brain radiotherapy (WBRT) is a mainstay of treatment. However, there is need to develop fractionation schedules, but total dose still remains dilemma. This prospective study aims to determine treatment outcome and prognostic factors by making comparison of long-course and short-course WBRT schedules.
Materials and Methods: Sixty patients presented with symptomatic brain metastases previously untreated with WBRT were randomized in two arms containing 30 patients. Arm A treated with 30 Gy, 3 Gy/fraction (fr.), 10 fr. and arm B 20 Gy, 4 Gy /fr. (5fr.). All patients were assessed during WBRT and after completion of WBRT.
Results: At 6 month of completion of WBRT objective response rate complete and partial (CR+PR) was 36.6% in arm A and 40% in arm B (p=0.72). WBRT regimen was not associated with survival (p=0.79). On multivariate analysis, age ≤ 65 years (p < 0.05), Karnofsky performance score (KPS) ≥ 70 (vs <70, p < 0.01), no extra-cranial metastases (p < 0.01) were significantly associated with improved survival.
Conclusions: This study suggests that two fractionation schedules showed comparable results. Therefore, short-course WBRT may be used as an effective option in favor of small treatment time and convenient for patients.
Keywords: Brain metastases, Whole Brain Radiotherapy, Fractionation schedules.
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