[Three-dimensional conformal hypofractionated radiotherapy for brain metastases of non-small-cell lung carcinoma: implications for whole brain irradiation].

OBJECTIVE

To evaluate the therapeutic effect of of whole brain irradiation (WBI) in the treatment of brain metastases of non-small-cell lung carcinoma and analyze the factors affecting the patients' survival.

METHODS

Ninety-three cases of brain metastases of non-small-cell lung carcinoma receiving radiotherapy between January 1998 and February 2004 were retrospectively reviewed. Of these patients, 68 were treated with three-dimensional conformal hypofractionated radiotherapy (3D-CRT) following WBI, while the other 25 underwent 3D-CRT alone. Kaplan-Meier method was used to analyze the survival rate and local control rate, and Cox proportional hazards model employed for determining prognostic factors influencing the patients' survival.

RESULTS

The overall median actuarial survival of the patients was 14 months in the 3D-CRT+WBI group with 1- and 2-year actuarial survival rates of 50% and 27%, respectively, showing no significant difference from 3D-CRT group, which had a median survival of 11 months and 1- and 2-year survival rates of 45% and 15% (P=0.502, log-rank test). Actuarial 1-year local control rate in 3D-CRT+WBI group was 90% as compared to 70% in 3D-CRT group (P=0.028, log-rank test). In multivariate analyses, active extracranial disease (P=0.002) and Karnofsky Performance Scale score (P=0.034) were identified as the independent prognostic factors for the patients' survival.

CONCLUSION

WBI prior to 3D-CRT does not benefit the patients with brain metastases of non-small cell lung carcinoma for their survival, but may help improve the local control rate.