COMPARATIVE STUDY OF PALLIATIVE WHOLE BRAIN RADIATION THERAPY BY 30 GY IN 10 VERSUS 20 GY IN 5 FRACTIONS IN THE TREATMENT OF PATIENTS WITH BRAIN METASTASIS.
Dr. Md Towfique Hasan Firoz and *Dr. Sanjida Khondakar Setu
ABSTRACT
Background: A shorter whole brain radiation therapy (WBRT) regimen with 20 Gy in 5 fractions in 5 days would be preferable with 30 Gy in 10 fractions in 2 weeks for patients with brain metastasis. Methods: Sixty patients with brain metastasis were enrolled 0ut of which in arm A, 30 patients were treated with 30 Gy in 10 fractions and in arm B, 30 patients received 20 Gy in 5 fractions palliative WBRT. Then the clinical responses were compared between these two arms. Results: 65% were male and 35% female among enrolled patients. Median age was 52.7years. 51.67% patient were of initially lung cancer followed by breast carcinoma (26.67%). Histopathology of primary tumor revealed 31.67% of adenocarcinoma, 26.67% of ductal carcinoma, 15% of each small cell carcinoma and squamous cell carcinoma. Majority of brain metastatic lesions were multiple in number (71.67%). Most of the metastatic lesions (93.34%) were located in the cerebral hemisphere. Headache, convulsion and cognitive dysfunction were improved better in short course therapy but nausea and vomiting were improved in standard therapy. Treatment related acute toxicities were more predominant in patients treated with short course therapy. Conclusion: Though the short course WBRT with 20 Gy in 5 fractions does increased toxicities it improved clinical response and less time consuming and thus appears preferable in patients with brain metastasis.
Keywords: brain metastasis, whole brain radiation therapy, 20 Gy in 5 fractions, 30 Gy in 10 fractions.
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