17 / a Single Institutional Experience on Whole Brain Radiotherapy as Primary Treatment for Brain Metastasis: a Retrospective Analysis of Patient Demographics, Prognostic Indices and Treatment-related Outcomes
Year: 2018
Type: other
Abstract: Introduction: Brain metastasis represents an increasingly critical problem among cancer survivors, and in low-resource centers, most are still treated with the classical whole brain radiotherapy (WBRT). Objectives: The purpose of this study is to provide an awareness regarding patient demographics, prognostic model indexes and treatment-related outcomes among patients treated with WBRT in a government hospital in a low-middle income country (LMIC) like the Philippines. Methods: Records of 86 patients who were treated with WBRT were retrospectively reviewed from June 2012 to October 2017, who neither underwent prior surgical excision nor radiosurgery. Results: Most patients received a total dose of 30 Gy in 10 fractions. Breast cancer represented the most common primary site (40%), followed closely by Lung Cancer (33%) and far behind are Cancers of Unknown Primary (10%). Majority (73%) have between 1-3 brain metastases on diagnosis and are commonly found in the cerebral cortices (85%). Headache (39%) is the primary symptom that prompted the patients to undergo WBRT. Two thirds of these patients were classified as Class II using the RTOG Recursive Partitioning Analysis (RPA). The median survival (MS) time among patients who completed the WBRT was 93 days (range 3-240). Among the different factors, only GPA showed statistical significance with the MS (p-value: 0.02). MS was positively correlated with GPA scores but negatively correlated with the RPA scores. Based on the Top 3 primary sites, breast was noted to have the best MS (73.9 days) while the unknown primary had the poorest MS (34.6 days). The total dose of 30 Gy WBRT had the best MS (93 days) compared to the higher 40 Gy with MS of 64 days.Conclusion: WBRT has been a primary management for brain metastasis in LMIC like the Philippines. Different prognostic factors affect the median survival of these patients. Goals of treatment focus more on palliation and improvement of quality of life.
Author: Jerickson Abbie Flores
Institution: José R. Reyes Memorial Medical Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4213077545