Whole-brain helical tomotherapy with integrated boost for brain metastases in patients with malignant melanoma – final results of the BRAIN-RT trial
Autor: | Justo Lorenzo Bermejo, Jürgen Debus, Henrik Hauswald, Florian Sterzing, David Krug, Denise Bernhardt, Gregor Habl, Sonja Katayama |
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Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Simultaneous integrated boost Poor prognosis medicine.medical_specialty medicine.medical_treatment tomotherapy Tomotherapy 03 medical and health sciences 0302 clinical medicine Quality of life brain metastases melanoma medicine Clinical endpoint In patient integrated boost Original Research business.industry Melanoma medicine.disease Radiation therapy 030104 developmental biology Oncology 030220 oncology & carcinogenesis Radiology hippocampal sparing business |
Zdroj: | Cancer Management and Research |
ISSN: | 1179-1322 |
Popis: | Background: Patients with multiple brain metastases (BMs) from malignant melanoma have a poor prognosis. Recent developments in radiation techniques allow simultaneous integrated boost (SIB) concepts while sparing organs at risk. Data on conventional versus dose-escalated radiation approaches in multiple BMs from malignant melanoma are warranted. Methods: In this prospective, single-center, randomized two-armed study (trial ID: DRKS00005127), patients with multiple BMs from malignant melanoma were treated with either conventional whole-brain radiotherapy (WBRT) applying 30 Gy in 10 fractions (standard arm) or helical tomotherapy applying 30 Gy to the whole brain with an integrated boost to metastases of 50 Gy in 10 fractions and sparing of the hippocampus (HA-WBRT, experimental arm). The primary endpoint was treatment-related toxicity, while secondary endpoints were imaging response, intracerebral progression-free survival (PFS), overall survival (OS) and quality of life. Results: The study was stopped early due to slow patient recruitment. A total number of 7 patients were enrolled (standard arm n=3, experimental arm n=4), and were followed-up for a median time of 5 months between August 2013 and July 2017. All patients were treated according to protocol. The median OS, intracerebral PFS and follow-up time were 5 months, 2 months and 5 months, respectively. The local control in every individual BM was significantly longer in the experimental versus the standard arm. No patient developed radiation-related high-grade toxicities. Conclusion: HA-WBRT with SIB results in improved local control in the individual melanoma BMs without radiation-associated high-grade toxicities. Survival times were comparable to published data. |
Databáze: | OpenAIRE |
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