Academic Journal
Palliative whole brain radiation therapy: an international state of practice
| العنوان: | Palliative whole brain radiation therapy: an international state of practice |
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| المؤلفون: | Keit, E., Lee, S. F., Woodward, Melissa, Rembielak, Agata, Shiue, K., Desideri, I., Oldenburger, E., Bienz, M., Rades, D., Theodorou, M., Agyeman, M. B., Yarney, J., Bryant, J. M., Yu, H. M., Simone, C. B., 2nd, Hoskin, Peter J, Johnstone, P. A. S. |
| المساهمون: | Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA |
| سنة النشر: | 2023 |
| المجموعة: | The Christie School of Oncology: Christie Research Publications Repository |
| الوصف: | Background: Improvements in radiation delivery and systemic therapies have resulted in few remaining indications for palliative whole brain radiation therapy (WBRT). Most centers preferentially use stereotactic radiotherapy (SRT) and reserve WBRT for those with >15 lesions, leptomeningeal presentation, rapidly progressive disease, or limited estimated survival. Despite regional differences among preferred dose, fractionation, and treatment technique, we predict survival post-WBRT will remain poor-indicating appropriate application of WBRT in this era of SRT and improved systemic therapies. Methods: A multi-center, international retrospective analysis of patients receiving WBRT in 2022 was performed. Primary end point was survival after WBRT. De-identified data were analyzed centrally. Patients receiving WBRT as part of a curative regimen, prophylactically, or as bridging therapy were excluded. The collected data consisted of patient parameters including prescription dose and fractionation, use of neurocognitive sparing techniques and survival after WBRT. Survival was calculated via the Kaplan-Meier method. Results: Of 29,943 international RT prescriptions written at ten participating centers in 2022, 462 (1.5%) were for palliative WBRT. Participating centers were in the United States (n=138), the United Kingdom (n=111), Hong Kong (n=72), Italy (n=49), Belgium (n=45), Germany (n=27), Ghana (n=15), and Cyprus (n=5). Twenty-six different dose regimens were used. The most common prescriptions were for 3,000 cGy over 10 fractions (45.0%) and 2,000 cGy over 5 fractions (43.5%) with significant regional preferences (P<0.001). Prior SRT was delivered in 32 patients (6.7%), hippocampal avoidance (HA) was used in 44 patients (9.5%), and memantine was prescribed in 93 patients (20.1%). Survival ranged from 0 days to still surviving at 402 days post-treatment. The global median overall survival (OS) was 84 days after WBRT [95% confidence interval (CI): 68.0-104.0]. Actuarial survival at 7 days, 1 month, 3 months, and ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | https://dx.doi.org/10.21037/apm-23-448; Keit E, Lee SF, Woodward M, Rembielak A, Shiue K, Desideri I, et al. Palliative whole brain radiation therapy: an international state of practice. Annals of palliative medicine. 2023 Sep 20. PubMed PMID: 37731303. Epub 2023/09/21. eng.; http://hdl.handle.net/10541/626589; Annals of Palliative Medicine |
| DOI: | 10.21037/apm-23-448 |
| الاتاحة: | http://hdl.handle.net/10541/626589 https://doi.org/10.21037/apm-23-448 |
| رقم الانضمام: | edsbas.7710FB0E |
| قاعدة البيانات: | BASE |
| DOI: | 10.21037/apm-23-448 |
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