Objective To investigate the shorter-term curative efficacy and safety of whole brain radio therapy(WBRT) combined with simultaneous integrated boost versus sequential integrated boost using image-guided intensity-modulated radiotherapy (IG-IMRT) for lung cancer patients with 1-4 brain metastases, and to confirm the optimal treatment scheme of lung cancer patients with brain metastases.
Methods We analyzed retrospectively the data of 98 patients diagnosed as brain metastases from lung cancer and admitted in our hospital from May 2014 to May 2017. The patients were divided into two groups: WBRT combined with simultaneous integrated boost (observation group, n=49) or WBRT combined with sequential integrated boost (control group, n=49) using image-guided intensity-modulated radiotherapy to compare the curative efficacy and safety. In the process of treatment, cone-beam CT(CBCT) was used to correct the position.
Results The total effective rate, local control rate and 1-year survival rate in the observation group were higher than those in the control group(87.80%(43/49) vs. 61.20%(30/49), 95.92%(47/49) vs. 81.60% (40/49), 65.31% (32/49) vs. 44.90% (22/49) (all P < 0.05). Median survival time in the observation group was higher than that in the control group(15 vs. 12 months). In addition, no 3-4 grades acute or late toxicities occurred. The main adverse effects included alopecia, nausea, vomiting, cognitive impairment and memory injury.
Conclusion Wholebrain radiotherapy combined with simultaneous integrated boost using image-guided intensity-modulated radiotherapy is a safe and effective treatment for the lung cancer patients with brain metastases.
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