Twice a day hypofractionated irradiation in patients with brain metastases. Final results of prospective non randomized study

Abstract

Aim

To evaluate the morbidity and effectivness of twice a day hypofractionation in patients with brain metastases.

Material / methods

Between 1992 and 2000, 116 patients with brain metastases have been treated with whole brain radiotherapy alone and only in 33 patients radiotherapy was applied as adjuvant treatment after surgery. Radiotherapy was given in two of 3 Gy fractions daily with minimum 6 hours intervals between fractions to total dose of 39 Gy. Mean age of treated patients was 55 years. All patients were in general performance status evaluated according to the Karnofsky Performance Scale of at least 50.

Results

Early tolerance of treatment was acceptable. Of 116 patients only 20 patients were treated with supportive treatment (anti-oedema drugs). Improvement of the neurological status was obtained in 26 patients (22%). The one-year overall survival was 21%. The one–year survival without clinical progression of disease was observed in 10% of all treated patients. Patients with solitary brain metastases treated with surgery and radiotherapy showed the best results.

Conclusions

Our results showed that twice a day hypo-fractionation radiotherapy for patients with brain metastases is well tolerated and may provides benefit.