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Efficacy observation of radiotherapeutic plans developed according to prognostic factors of brain metastases

This study aimed to assess the efficacies of different radiotherapeutic plans for brain metastases (BM). A total of 110 patients with BM treated from January 2008 to December 2012 were retrospectively included, and divided into the standard group (n=57) and the auxo-dose group (n=53) according to their Karnofsky scores (KPS) and extracranial lesions. The standard group underwent whole brain radiotherapy with 30 Gy in 10 doses over 2 weeks, while the auxo-dose group received an increased local boost dose compared to the standard group, according to the number and invasiveness of the metastases. The follow-up lasted 2 years to observe the effect of local auxo-dosage on the prognosis of BM. The median survival time (17 months vs. 5 months), 1-year survival rate (69.8% vs. 33.3%), and 2-year survival rate (41.5% vs. 0) of the auxo-dose group were higher than those of the standard group. The 1- year complete remission (42.5% vs. 13.3%) and 1-year partial remission (48.8% vs. 6.7%) rates of BM in the auxo-dose group were higher than that in the standard group; 48 patients of the auxo-dose group died, with the main cause being extracranial tumor (60.4%, 29/48). All patients of the standard group died during the observation period, with the main cause as intracranial tumor (42.1%, 24/57). All of the above comparisons were significant (P<0.05). Compared with standardized whole-brain radiation therapy, radiotherapy with an additional local dose improved remission rates while reducing the longterm mortality of BM.

Author(s): Tangbing Wu, Dejun Qian, Xiaoyi Sun, Huiming Bai, Jing Wang