External Beam Boost Combined With Whole-Brain Radiation Therapy Improves Survival for Patients With Lung Cancer Metastases

Whole-brain radiation therapy combined with a conformational external beam radiation boost dose of greater than 39 Gy was associated with a significant increase in overall and progression-free survival in a recent multi-institutional study published in the Feb. 18, 2010, Radiation Oncology at http://www.ro-journal.com/content/5/1/13.

Nathalie Casanova, et al, used whole-brain radiation therapy (WBRT) combined with a radiation therapy boost (RTB) to treat 53 patients with lung cancer that had metastasized to the brain. The mean age was 58.8 years and the median number of brain metastasis was one. A total of 38 participants underwent surgery.

During follow-up, the authors found that 37 (70 percent) of the patients had died, with a median overall survival of 14.5 months. Overall survival was significantly associated with a total dose of greater than 39 Gy, being younger than 65 and the absence of extracranial metastasis. The study did not assess the long-term neurocognitive effect of this strategy.

“This analysis of the outcome of 53 lung cancer patients with brain metastasis treated with WBRT and RTB reveals an increase in overall survival and progression-free survival for patients treated with higher radiation doses,” concluded the authors. “Only one-quarter of the studied cohort presented with local failure.”