Affiliation:
1. Resident, Radiotherapy , SMS Medical college and attached hospitals, Jaipur
2. Senior Professor , Radiotherapy , SMS Medical college and attached hospitals, Jaipur
Abstract
Purpose of study : To compare the treatment outcomes in patients with brain metastasis treated with two different fractionation schedules of whole
brain radiotherapy. A prospective randomised study was carried out on newly diagnosed cancer patients with MRIMaterials and methods:
diagnosis of brain metastasis. Patients with multiple bm with Eastern Cooperative Oncology Group performance status 0-4 were included. In Arm
A, patients received whole brain radiotherapy (WBRT) of total dose 30 GY , 3Gy/fraction/10# over 2 weeks ,whereas , in Arm-B patients received
total dose of 20 GY in 4Gy/fraction/5# over 1 week. Assessment of improvement in clinical symptoms was done using BARTHEL'S ADJUSTED
DAILY LIVE (ADL)14 Score before treatment, just after treatment and 6 week of treatment and improvement was analysed. At three months
follow up , radiological response was carried out by MRI scan of brain. Acute toxicities were assessed during treatment and follow up ( up to 90
days post EBRT ) using clinical status, laboratory investigations and radiological test and graded according to RTOG/EORTC criteria. Results:
Signicant improvement in terms of ADL score was observed in both arms , however when both arms were compared , no signicant difference
was found out. There was no statistically signicant difference in response or morbidity between the two treatment arms. In theConclusions:
palliative setting short duration of treatment with minimum discomfort to the patient is desirable. 20 Gy in 5 fractions is equally effective as 30 Gy
in 10 fractions, with slight advantage in terms of toxicity. Thus 20 Gy in 5 fractions can be preferred in brain metastasis patients, especially those
with poor performance status.
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