International Journal of Radiation Oncology * Biology * Physics
Volume 77, Issue 3 , Pages 648-654 , 1 July 2010

Randomized Comparison of Whole Brain Radiotherapy, 20 Gy in Four Daily Fractions Versus 40 Gy in 20 Twice-Daily Fractions, for Brain Metastases

  • P.H. Graham, M.B., B.S., F.R.A.N.Z.C.R., Cert.Bioethics., G.Dip.Med.Stat.

      Affiliations

    • Cancer Care Centre, St. George Hospital, Kogarah, Australia
    • Corresponding Author InformationReprint requests to: P. H. Graham, M.B., B.S., F.R.A.N.Z.C.R., Cert.Bioethics., G.Dip.Med.Stat., Cancer Care Centre, St. George Hospital, Kogarah 2217 Australia. Tel: (+61) 2-9113-3934; Fax: (+61) 2-9113-3958
  • ,
  • J. Bucci, M.B., B.S., F.R.A.C.P., F.R.A.N.Z.C.R.

      Affiliations

    • Cancer Care Centre, St. George Hospital, Kogarah, Australia
  • ,
  • L. Browne, B.Sc., Ph.D., G.Dip.Med.Stats., M.Med.Stats., A.Stat.

      Affiliations

    • Cancer Care Centre, St. George Hospital, Kogarah, Australia

Received 10 April 2009 ,Revised 24 May 2009 ,Accepted 26 May 2009.

References 

  1. Horton J, Baxter GH, Olsen KB. The management of metastases to the brain by irradiation and corticosteroids. AJR Am J Roentgen Radiat Ther Nucl Med. 1971;3:334–346
  2. Epstein BE, Scott CB, Sause WT, et al. Improved survival duration in patients with unresected solitary brain metastases using accelerated hyperfractionated radiation therapy at total doses of 54.4 Gray and greater: Results of Radiation Oncology Therapy Group 85-28. Cancer. 1993;71:1362–1367
  3. Harwood AR, Simpson WJ. Radiation therapy of cerebral metastases: A randomized prospective clinical trial. Int J Radiat Oncol Biol Phys. 1977;2:1091–1094
  4. Davey P, Hoegler D, Ennis M, et al. A phase III study of accelerated versus conventional hypofractionated whole brain irradiation in patients of good performance status with brain metastases not suitable for surgical excision. Radiother Oncol. 2008;88:173–176
  5. Gelber RD, Larson M, Borgelt BB, et al. Equivalence of radiation schedules for the palliative treatment of brain metastases in patients with favourable prognosis. Cancer. 1981;48:1749–1753
  6. Patchell RA, Tibs PA, Walsh JW, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322:494–500
  7. Vecht CJ, Haaxme-Reiche H, Noordijk EM, et al. Treatment of single brain metastasis: Radiotherapy alone or combined with neurosurgery?. Ann Neurol. 1993;33:583–590
  8. Noordijk EM, Vecht CJ, Haaxma-Reiche H, et al. The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age. Int J Radiat Oncol Biol Phys. 1994;29:711–717
  9. Priestman TJ, Dunn J, Brada M, et al. Final results of the Royal College of Radiologists’ Trial comparing two different radiotherapy schedules in the treatment of cerebral metastases. Clin Oncol. 1996;8:308–315
  10. Murray KJ, Scott C, Greenberg HM, et al. A randomized phase III study of accelerated hyperfractionation versus standard in patients with unresected brain metastases: A report of the Radiation Therapy Oncology Group (RTOG) 9104. Int J Radiat Oncol Biol Phys. 1997;39:571–574
  11. Kondziolka D, Patel A, Lunsford LD, et al. Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys. 1999;45:427–434
  12. Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet. 2004;363:1665–1672
  13. Patchell RA, Tibbs PA, Regine WF, et al. Postoperative radiotherapy in the treatment of single metastases to the brain: A randomized trial. JAMA. 1998;280:1485–1489
  14. Lohr F, Pirzkall A, Hof H, et al. Adjuvant treatment of brain metastases. Semin Surg Oncol. 2001;20:50–56
  15. Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys. 1997;37:745–751
  16. Regine WF, Scot C, Murray K, et al. Neurocognitive outcome in brain metastases patients treated with accelerated-fractionation vs accelerated-hyperfractionated radiotherapy: An analysis from Radiation Therapy Oncology Group Study 91-04. Int J Radiat Oncol Biol Phys. 2001;51:711–717
  17. Shilling V, Jenkins V. Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer. Eur J Oncol Nurs. 2007;11:6–15
  18. Arriagada R, Le Chevalier T, Borie F, et al. Prophylactic cranial irradiation for patients with small cell lung cancer in complete remission. J Natl Cancer Inst. 1995;87:183
  19. Gregor A, Cull A, Stephens RJ, et al. for the United Kingdom Coordinating Committee for Cancer Research (UKCCCR) and the European Organization for Research and Treatment of Cancer (EORTC)Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: Results of a multicentre randomised trial. Eur J Cancer. 1997;33:1752

 Conflict of interest: none.

PII: S0360-3016(09)00795-0

doi: 10.1016/j.ijrobp.2009.05.032

International Journal of Radiation Oncology * Biology * Physics
Volume 77, Issue 3 , Pages 648-654 , 1 July 2010