Adjuvant Whole-Brain Radiotherapy Versus Observation After Radiosurgery or Surgical Resection of One to Three Cerebral Metastases: Results of the EORTC 22952-26001 Study

Autor: Rolf-Peter Mueller, Rolf-Dieter Kortmann, Dirk van den Berge, Ufuk Abacioglu, Mohamed Ben Hassel, Salvador Villà, Christian Carrie, Laurence Collette, François Fauchon, Sandra Collette, Tzahala Tzuk-Shina, L. Fariselli, Martin Kocher, Riccardo Soffietti, Mauri Kouri, Brigitta G. Baumert, Egils Valeinis
Přispěvatelé: Radiotherapie, RS: GROW - School for Oncology and Reproduction
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Adult
Male
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Salvage therapy
Radiosurgery
Disease-Free Survival
Metastasis
radiotherapy/secondary/surgery/therapy
Adult
Aged
Aged
80 and over
Brain Neoplasms
radiotherapy/secondary/surgery/therapy
Disease Progression
Disease-Free Survival
Female
Humans
Male
Middle Aged
Radiosurgery
adverse effects
Radiotherapy
Adjuvant
Radiotherapy
adverse effects
Salvage Therapy
Survival Rate
Original Reports
medicine
Clinical endpoint
80 and over
Humans
Lung cancer
Survival rate
Adjuvant
Aged
Aged
80 and over
Salvage Therapy
Performance status
Radiotherapy
business.industry
Brain Neoplasms
Middle Aged
medicine.disease
Surgery
Radiation therapy
Survival Rate
Oncology
Disease Progression
adverse effects
Radiotherapy
Adjuvant
Female
business
Zdroj: Journal of Clinical Oncology, 29(2), 134-141. American Society of Clinical Oncology
ISSN: 1527-7755
0732-183X
Popis: Purpose This European Organisation for Research and Treatment of Cancer phase III trial assesses whether adjuvant whole-brain radiotherapy (WBRT) increases the duration of functional independence after surgery or radiosurgery of brain metastases. Patients and Methods Patients with one to three brain metastases of solid tumors (small-cell lung cancer excluded) with stable systemic disease or asymptomatic primary tumors and WHO performance status (PS) of 0 to 2 were treated with complete surgery or radiosurgery and randomly assigned to adjuvant WBRT (30 Gy in 10 fractions) or observation (OBS). The primary end point was time to WHO PS deterioration to more than 2. Results Of 359 patients, 199 underwent radiosurgery, and 160 underwent surgery. In the radiosurgery group, 100 patients were allocated to OBS, and 99 were allocated to WBRT. After surgery, 79 patients were allocated to OBS, and 81 were allocated to adjuvant WBRT. The median time to WHO PS more than 2 was 10.0 months (95% CI, 8.1 to 11.7 months) after OBS and 9.5 months (95% CI, 7.8 to 11.9 months) after WBRT (P = .71). Overall survival was similar in the WBRT and OBS arms (median, 10.9 v 10.7 months, respectively; P = .89). WBRT reduced the 2-year relapse rate both at initial sites (surgery: 59% to 27%, P < .001; radiosurgery: 31% to 19%, P = .040) and at new sites (surgery: 42% to 23%, P = .008; radiosurgery: 48% to 33%, P = .023). Salvage therapies were used more frequently after OBS than after WBRT. Intracranial progression caused death in 78 (44%) of 179 patients in the OBS arm and in 50 (28%) of 180 patients in the WBRT arm. Conclusion After radiosurgery or surgery of a limited number of brain metastases, adjuvant WBRT reduces intracranial relapses and neurologic deaths but fails to improve the duration of functional independence and overall survival.
Databáze: OpenAIRE
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