The Effects Of Various Radiotherapies In Lung Cancer With Brain Metastasis

Purpose: To evaluate the effects of various radiotherapeutic models for brainmetastasis from lung cancer. Methods: One hundred and sixty-four lung cancerpatients with brain metastasis pathologically proved were divided into fourgroups: 32 cases were whole brain radiotherapy (WBRY)alone, 51 cases werestereotactic radiosurgery(SRS) combined with WBRT, 40cases were stereotacticradiotherapy(SRT) combined with WBRT. 41 cases were stereotacticradiosurgery(SRS) alone. The dose fraction of whole brain radiotherapy was3600cGy～4000cGy in 18 to 20 fractions, 180cGy～200cGy perfraction. Stereotactic radiosurgery(SRS)were combined with whole brainradiotherapy (WBRY)before or behind , In stereotactic radiosurgery(SRS),singletumor target dose ranged from 1200cGy to 1600cGy, and the dose fraction ofwhole brain radiotherapy was 3200cGy～3600cGy in 16 to 18 fractions. Instereotactic radiotherapy(SRT)group,single tumor target dose ranged from 300cGy to500cGy with total dose 2500cGy to 6000cGy. Results: The response rates in fourgroups were 46.9%,78.9%,87.5%,78%,;median survival were 5.0,12.0, 12.0,10.0months respectively;the median of progression free survival(PFS) was4.0,9.56,9.5,8.5 months;the median survival willout new brain metastasis was4.0,10.5,9.0,8.5 months respeclively.There were 62.5% patients in WBRT alone failed due to brain metastasis, the significant difference to the other 3 groups wasfound (P=0.000). The long term complication rate in stereotactic radiosurgery(SRS)combined with WBRT group was 23.5%, the difference was statisticlly significantcompared with other 3 groups. Conclusion: SRS alone is the optional treatment forsingle brain metastasis. For multi-metastasis of brain, the effect of SRT combinedwith WBRT is better than that of other treatrments, not only in improving survival,butalso in reducing complication.