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TEK BEYİN METASTAZLI HASTALARDA TÜM BEYİN + SİMÜLTANE ENTEGRE BOOST RADYOTERAPİSİ

Year 2016, Volume: 38 Issue: 3, 40 - 45, 06.06.2016

Abstract

ÖZET: Bu çalışmanın amacı tek beyin metastazına sahip küçük
hücreli dışı akciğer kanseri (KHDAK) tanılı hastalarda yoğunluk ayarlı
radyoterapi (YART) planlama yöntemi ile tüm beyin radyoterapisi + simültane
entegre
boost (TBRT + SEB) tekniğini
kullanarak hedef dokuda doz yükseltilmesinin erken dönem sonuçlarının
değerlendirmesidir. Tek beyin metastazına sahip ve TBRT + SEB tedavisi
uygulanan KHDAK tanılı hastalar geriye dönük olarak değerlendirildi. Temmuz
2015 - Ocak 2016 arasında toplamda 11 hastaya ulaşıldı. Hasta ve tümöre ait
özellikler, demografik veriler, tedavi bilgisi ve özellikleri incelendi. Tedavi
süresince tüm hastalara antiödem tedavi rutin başlandı. Hastalarda grade III-IV
toksisite gözlemlenmedi. Hastaların radyoterapiden 1 ay sonra çekilen beyin MR
görüntüleri değerlendirildi ve tedavi öncesi beyin MR görüntüleri ile
karşılaştırılarak 7 (%63) hastada tam yanıt, 4 (%37) hastada ise kısmi yanıt
elde tespit edildi. Sonuç olarak TBRT + SEB tekniği radyocerrahi uygulamasına
göre teknik olarak daha basit uygulanabilir, oldukça etkin ve hastalar
tarafından tolere edilebilir bir yöntemdir.

ANAHTAR KELİMELER: tüm beyin
radyoterapisi (TBRT), simültane entegre
boost
(SEB), akciğer kanseri, tek beyin metastazı


WHOLE BRAIN RADIOTHERAPY (WBRT) WITH
SIMULTANEOUS INTEGRATED BOOST (SIB) IN PATIENTS WITH SINGLE BRAIN METASTASIS


ABSTRACT: The aim of
this study is to evaluate the early phase treatment results of dose escalation
using by whole brain radiotherapy (WBRT) with simultaneous integrated boost
(SIB) in non-small cell lung cancer patients with single brain metastasis. We
evaluated retrospectively non-small cell lung cancer patients treated with WBRT
+ SIB. We achieved the data of 11 non-small cell lung cancer patients who were
treated between July 2015 and January 2016. Patient and tumor characteristics,
demographic data and treatment features have been evaluated. We prescribed
antiedema treatment to all patients in whole duration of radiotherapy. We did
not observe any grade III-IV toxicity. Cranial MRI images in the first month
after radiotherapy has been evaluated and compared with preradiotherapy images.
Complete response was identified in 7 (63%) patients and partial response was
identified in 4 (37%) patients. In conclusion, WBRT + SIB technique is easier
to apply when compared with radiosurgery, an effective and tolerable method for
patients.













KEYWORDS: Whole
brain radiotherapy (WBRT), simultaneous integrated boost (SIB), lung cancer,
single brain metastasis

References

  • 1. Ellis, T. L., Neal, M. T., & Chan, M. D. (2011). The role of surgery, radiosurgery and whole brain radiation therapy in the management of patients with metastatic brain tumors. International journal of surgical oncology, 2012.
  • 2. Norden, A.D., Wen, P.Y., Kesari, S. (2005). Brain metastases. Curr Opin Neurol, 18(6):654-661.
  • 3. Rahmathulla, G., Toms, S. A., & Weil, R. J. (2012). The molecular biology of brain metastasis. Journal of oncology, 2012.
  • 4. Gupta, T. (2005). Stereotactic radiosurgery for brain oligometastases: good for some, better for all?. Annals of oncology, 16(11), 1749-1754.
  • 5. Weber, D. C., Caparrotti, F., Laouiti, M., & Malek, K. (2011). Simultaneous in-field boost for patients with 1 to 4 brain metastasis/es treated with volumetric modulated arc therapy: a prospective study on quality-of-life. Radiation Oncology, 6(1),
  • 6. Kondziolka, D., Patel, A., Lunsford, L. D., Kassam, A., & Flickinger, J. C. (1999). Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. International Journal of Radiation Oncology* Biology* Physics, 45(2), 427-434.
  • 7. Andrews, D. W., Scott, C. B., Sperduto, P. W., Flanders, A. E., Gaspar, L. E., Schell, M. C., ... & Souhami, L. (2004). Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. The Lancet,363(9422), 1665-1672.
  • 8. Casanova, N., Mazouni, Z., Bieri, S., Combescure, C., Pica, A., & Weber, D. C. (2010). Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study. Radiation oncology, 5(1), 1.
  • 9. Bruzzaniti, V., Abate, A., Pedrini, M., Benassi, M., & Strigari, L. (2011). IsoBED: a tool for automatic calculation of biologically equivalent fractionation schedules in radiotherapy using IMRT with a simultaneous integrated boost (SIB) technique. Journal of Experimental & Clinical Cancer Research, 30(1), 1.
  • 10. Tsao, M. N., Khuntia, D., & Mehta, M. P. (2012). Brain metastases: what's new with an old problem?. Current opinion in supportive and palliative care, 6(1), 85-90.
  • 11. Khuntia, D., Brown, P., Li, J., & Mehta, M. P. (2006). Whole-brain radiotherapy in the management of brain metastasis. Journal of Clinical Oncology, 24(8), 1295-1304.
  • 12. Assouline, A., Levy, A., Chargari, C., Lamproglou, I., Mazeron, J. J., & Krzisch, C. (2011). Whole brain radiotherapy: prognostic factors and results of a radiation boost delivered through a conventional linear accelerator. Radiotherapy and Oncology, 99(2), 214-217
  • 13. Akhtar, M. S., Kousar, F., Fatmi, S., Jabeen, K., & Akhtar, K. (2012). Quality of life and symptoms control in brain metastasis after palliative whole brain radiotherapy using two different protocols. J Coll Physicians Surg Pak, 22(5), 311-316.
  • 14. Rades, D., Kueter, J. D., Gliemroth, J., Veninga, T., Pluemer, A., & Schild, S. E. (2012). Resection plus whole-brain irradiation versus resection plus whole-brain irradiation plus boost for the treatment of single brain metastasis. Strahlentherapie und Onkologie, 188(2), 143-147.
  • 15. Edwards, A.A., Keggin, E., Plowman, P.N. (2010). The developing role for intensity-modulated radiation therapy (IMRT) in the non-surgical treatment of brain metastases. Br J Radiol, 83(986):133-136.
Year 2016, Volume: 38 Issue: 3, 40 - 45, 06.06.2016

Abstract

References

  • 1. Ellis, T. L., Neal, M. T., & Chan, M. D. (2011). The role of surgery, radiosurgery and whole brain radiation therapy in the management of patients with metastatic brain tumors. International journal of surgical oncology, 2012.
  • 2. Norden, A.D., Wen, P.Y., Kesari, S. (2005). Brain metastases. Curr Opin Neurol, 18(6):654-661.
  • 3. Rahmathulla, G., Toms, S. A., & Weil, R. J. (2012). The molecular biology of brain metastasis. Journal of oncology, 2012.
  • 4. Gupta, T. (2005). Stereotactic radiosurgery for brain oligometastases: good for some, better for all?. Annals of oncology, 16(11), 1749-1754.
  • 5. Weber, D. C., Caparrotti, F., Laouiti, M., & Malek, K. (2011). Simultaneous in-field boost for patients with 1 to 4 brain metastasis/es treated with volumetric modulated arc therapy: a prospective study on quality-of-life. Radiation Oncology, 6(1),
  • 6. Kondziolka, D., Patel, A., Lunsford, L. D., Kassam, A., & Flickinger, J. C. (1999). Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. International Journal of Radiation Oncology* Biology* Physics, 45(2), 427-434.
  • 7. Andrews, D. W., Scott, C. B., Sperduto, P. W., Flanders, A. E., Gaspar, L. E., Schell, M. C., ... & Souhami, L. (2004). Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. The Lancet,363(9422), 1665-1672.
  • 8. Casanova, N., Mazouni, Z., Bieri, S., Combescure, C., Pica, A., & Weber, D. C. (2010). Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study. Radiation oncology, 5(1), 1.
  • 9. Bruzzaniti, V., Abate, A., Pedrini, M., Benassi, M., & Strigari, L. (2011). IsoBED: a tool for automatic calculation of biologically equivalent fractionation schedules in radiotherapy using IMRT with a simultaneous integrated boost (SIB) technique. Journal of Experimental & Clinical Cancer Research, 30(1), 1.
  • 10. Tsao, M. N., Khuntia, D., & Mehta, M. P. (2012). Brain metastases: what's new with an old problem?. Current opinion in supportive and palliative care, 6(1), 85-90.
  • 11. Khuntia, D., Brown, P., Li, J., & Mehta, M. P. (2006). Whole-brain radiotherapy in the management of brain metastasis. Journal of Clinical Oncology, 24(8), 1295-1304.
  • 12. Assouline, A., Levy, A., Chargari, C., Lamproglou, I., Mazeron, J. J., & Krzisch, C. (2011). Whole brain radiotherapy: prognostic factors and results of a radiation boost delivered through a conventional linear accelerator. Radiotherapy and Oncology, 99(2), 214-217
  • 13. Akhtar, M. S., Kousar, F., Fatmi, S., Jabeen, K., & Akhtar, K. (2012). Quality of life and symptoms control in brain metastasis after palliative whole brain radiotherapy using two different protocols. J Coll Physicians Surg Pak, 22(5), 311-316.
  • 14. Rades, D., Kueter, J. D., Gliemroth, J., Veninga, T., Pluemer, A., & Schild, S. E. (2012). Resection plus whole-brain irradiation versus resection plus whole-brain irradiation plus boost for the treatment of single brain metastasis. Strahlentherapie und Onkologie, 188(2), 143-147.
  • 15. Edwards, A.A., Keggin, E., Plowman, P.N. (2010). The developing role for intensity-modulated radiation therapy (IMRT) in the non-surgical treatment of brain metastases. Br J Radiol, 83(986):133-136.
There are 15 citations in total.

Details

Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Alaattin Özen

Suzan Şaylısoy This is me

Evrim Metcalfe This is me

Durmuş Etiz This is me

Publication Date June 6, 2016
Published in Issue Year 2016 Volume: 38 Issue: 3

Cite

Vancouver Özen A, Şaylısoy S, Metcalfe E, Etiz D. TEK BEYİN METASTAZLI HASTALARDA TÜM BEYİN + SİMÜLTANE ENTEGRE BOOST RADYOTERAPİSİ. Osmangazi Tıp Dergisi. 2016;38(3):40-5.


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