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Radiation Oncology
Published in: Radiation Oncology 1/2011

Open Access 01-12-2011 | Research

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

Authors: Damien C Weber, Francesca Caparrotti, Mohamed Laouiti, Karim Malek

Published in: Radiation Oncology | Issue 1/2011

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Abstract

Purpose

To assess treatment toxicity and patients' survival/quality of life (QoL) after volumetric modulated arc therapy (VMAT) with simultaneous in-field boost (SIB) for cancer patients with 1 - 4 brain metastases (BM) treated with or without surgery.

Methods and Materials

Between March and December 2010, 29 BM patients (total volume BM, < 40 cm3) aged < 80 years, KPS ≥ 70, RPA < III were included in this prospective trial. Whole brain VMAT (30 Gy) and a SIB to the BM (40 Gy) was delivered in 10 fraction. Mean age was 62.1 ± 8.5 years. Fifteen (51.7%) underwent surgery. KPS and MMSE were prospectively assessed. A self-assessed questionnaire was used to assess the QoL (EORTC QLQ-C30 with -BN20 module).

Results

As of April 2011 and after a mean FU of 5.4 ± 2.8 months, 14 (48.3%) patients died. The 6-month overall survival was 55.1%. Alopecia was only observed in 9 (31%) patients. In 3-month survivors, KPS was significantly (p = 0.01) decreased. MMSE score remained however stable (p = 0.33). Overall, QoL did decrease after VMAT. The mean QLQ-C30 global health status (p = 0.72) and emotional functional (p = 0.91) scores were decreased (low QoL). Physical (p = 0.05) and role functioning score (p = 0.01) were significantly worse and rapidly decreased during treatment. The majority of BN20 domains and single items worsened 3 months after VMAT except headaches (p = 0.046) and bladder control (p = 0.26) which improved.

Conclusions

The delivery of 40 Gy in 10 fractions to 1 - 4 BM using VMAT was achieved with no significant toxicity. QoL, performance status, but not MMSE, was however compromised 3 months after treatment in this selected cohort of BM patients.
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Metadata
Title
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
Authors
Damien C Weber
Francesca Caparrotti
Mohamed Laouiti
Karim Malek
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-6-79

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