Optimizing Whole Brain Radiotherapy Treatment and Dose for Patients With Brain Metastases From Small Cell Lung...

Area of Science:

• Radiation Oncology
• Medical Oncology
• Neuro-oncology

Background:

• Brain metastasis (BM) is a common complication in small cell lung cancer (SCLC).
• Whole brain radiotherapy (WBRT) is a standard treatment for BM, but its efficacy can be limited.
• Optimizing radiotherapy techniques may improve outcomes for SCLC patients with BM.

Purpose of the Study:

• To compare survival outcomes between WBRT and WBRT with a local radiation boost (WBRT + boost) in SCLC patients with BM.
• To determine if a higher biologically effective dose (BED) of WBRT + boost confers a survival advantage.

Main Methods:

• Retrospective analysis of 180 SCLC patients with BM treated between 2012 and 2019.
• Kaplan-Meier method and log-rank test for overall survival (OS) and intracranial progression-free survival (iPFS) analysis.
• Cox regression models for prognostic factor analysis and ROC curve for BED cutoff determination.

Main Results:

• WBRT + boost demonstrated significantly superior OS (median 20 vs. 14 months) and iPFS (median 16 vs. 10 months) compared to WBRT alone.
• In the WBRT + boost group, a high BED (>58.35 Gy) was associated with improved OS (median 23 vs. 17 months) and iPFS (median 17 vs. 10 months) compared to low BED.

Conclusions:

• WBRT + boost significantly improves OS and iPFS in SCLC patients with BM compared to WBRT alone.
• A high BED (>58.35 Gy) for WBRT + boost is a promising strategy for enhancing survival in this patient population.