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The palliation of brain metastases: Final results of the first two studies by the radiation therapy oncology group

1980; Elsevier BV; Volume: 6; Issue: 1 Linguagem: Inglês

10.1016/0360-3016(80)90195-9

1879-355X

B.B. Borgelt, Richard D. Gelber, Simon Krämer, Luther W. Brady, Chu H. Chang, Lawrence W. Davis, Carlos A. Perez, Frank R. Hendrickson,

Glioma Diagnosis and Treatment

Five schedules of whole brain irradiation ranging from 4000 rad/4 weeks to 2000 rad/ 1 week have been evaluated in two sequential phase III randomized Radiation Therapy Oncology Group (RTOG I studies to determine palliative effectiveness in patients with metastatic brain disease. Improvement in neurologic function status and maintenance of improved or stable neurologic function were utilized as measures of response. All treatment schedules were comparable with respect to frequency of improvement, duration of improvement, time to progression, survival and palliative index. Important prognosticators of response included initial neurologic function and general performance status. Administration of steroids during irradiation favored more rapid improvement; for neurologic-function-3 patients, it increased the overall frequency of improvement. This result must be interpreted with caution since the administration of steroids was not controlled in either study. Patients whose disease is controlled at the primary site and in whom brain is the only site of metastases, constitute a prognostically favorable group; they may benefit from whole brain irradiation to higher doses. This population is currently under investigation in a third RTOG study.