Fractionated Stereotactic Radiotherapy for Metastatic Brain Tumor in Non-Small Cell Lung Cancer

ABSTRACT

PURPOSE: To evaluate the results of treatment with fractionated stereotactic radiotherapy for metastatic brain tumors in non-small cell lung cancer. MATERIALS AND METHODS: Between August 1997 and August 2001, 17 patients, with metastatic brain tumors in non-small cell lung cancer (26 lesions), completed frameless fractionated stereotactic radiotherapy. All patients received a 30~36 Gy/10~20 fx external beam irradiation to the whole brain. Twelve received fractionated stereotactic radiotherapy for a single lesion, 3 for 2 lesions and 1 each for 3 and 5 lesions. The median tumor volume was 1.7 cc (0.3~55.2 cc). The fractionation schedule for the fractionated stereotactic radiotherapy was 21 Gy/3 fx in 8 lesions, 25 Gy/5 fx in 7, 18 Gy/1 fx in 6, 30 Gy/5 fx in 4 and 15 Gy/5 fx in 1. Multiple-arc, and 3D conformal, fractionated stereotactic radiotherapy, were delivered to 24 and 2 lesions, respectively. Follow-up was possible in all patients. RESULTS: Nine out of 13 patients with follow-up radiological evaluations achieved a complete response (CR). The overall median survival, and 1 and 2 year survival rates were 20 months, and 64 and 28%, respectively. The median survival, and the 1 and 2 year survival rate of CR group were 20 months, and 73 and 22%, respectively. No patient has experienced any acute side reactions or late complications from the fractionated stereotactic radiotherapy. CONCLUSION: Although the number of patients treated with fractionated stereotactic radiotherapy was small, and follow-up period short, this study suggests that external beam irradiation to the whole brain, with 30 Gy/10 fx followed by fractionated stereotactic radiotherapy, could be a good treatment option for patients with metastatic brain tumors in non-small cell lung cancer.