Phase II clinical trial of whole-brain irradiation plus three-dimensional conformal boost with concurrent topotecan for brain metastases from lung cancer

Patients with brain metastases from lung cancer have poor prognoses and short survival time, and they are often excluded from clinical trials. Whole-cranial irradiation is considered to be the standard treatment, but its efficacy is not satisfactory. The purpose of this phase II clinical trial was t...

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Bibliographic Details
Published in:Radiation oncology (London, England) England), 2013-10, Vol.8 (1), p.238-238, Article 238
Main Authors: Ge, Xiao-Hui, Lin, Qiang, Ren, Xiao-Cang, Liu, Yue-E, Chen, Xue-Ji, Wang, Dong-Ying, Wang, Yong-Qiang, Cao, Bin, Li, Zhi-Gang, Liu, Miao-Ling
Format: Article
Language:English
Subjects:
Abdomen
Adult
Aged
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Blood-brain barrier
Brain cancer
Brain damage
Brain Neoplasms - mortality
Brain Neoplasms - secondary
Brain Neoplasms - therapy
Cancer therapies
Carcinoma, Non-Small-Cell Lung - mortality
Carcinoma, Non-Small-Cell Lung - secondary
Carcinoma, Non-Small-Cell Lung - therapy
Care and treatment
Chemoradiotherapy - methods
Chemotherapy
Clinical trials
Complications and side effects
Cranial Irradiation - methods
Disease
Disease-Free Survival
Esophageal cancer
Family medical history
Feasibility studies
Female
Health aspects
Hospitals
Humans
Kaplan-Meier Estimate
Lung cancer
Lung Neoplasms - mortality
Lung Neoplasms - pathology
Lung Neoplasms - therapy
Male
Middle Aged
NMR
Nuclear magnetic resonance
Oncology
Radiation therapy
Radiotherapy
Radiotherapy, Conformal - methods
Risk factors
Small Cell Lung Carcinoma - mortality
Small Cell Lung Carcinoma - secondary
Small Cell Lung Carcinoma - therapy
Topotecan - administration & dosage
Topotecan - adverse effects
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Summary:Patients with brain metastases from lung cancer have poor prognoses and short survival time, and they are often excluded from clinical trials. Whole-cranial irradiation is considered to be the standard treatment, but its efficacy is not satisfactory. The purpose of this phase II clinical trial was to evaluate the preliminary efficacy and safety of the treatment of whole-brain irradiation plus three-dimensional conformal boost combined with concurrent topotecan for the patients with brain metastases from lung cancer. Patients with brain metastasis from lung cancer received concurrent chemotherapy and radiotherapy: conventional fractionated whole-brain irradiation, 2 fields/time, 1 fraction/day, 2 Gy/fraction, 5 times/week, and DT 40 Gy/20 fractions; for the patients with ≤ 3 lesions with diameter ≥ 2 cm, a three-dimensional (3-D) conformal localised boost was given to increase the dosage to 56-60 Gy; and during radiotherapy, concurrent chemotherapy with topotecan was given (the chemoradiotherapy group, CRT). The patients with brain metastasis from lung cancer during the same period who received radiotherapy only were selected as the controls (the radiotherapy-alone group, RT). From March 2009 to March 2012, both 38 patients were enrolled into two groups. The median progression-free survival(PFS) time , the 1- and 2-year PFS rates of CRT group and RT group were 6 months, 42.8%, 21.6% and 3 months, 11.6%, 8.7% (χ2 = 6.02, p = 0.014), respectively. The 1- and 2-year intracranial lesion control rates of CRT and RT were 75.9% , 65.2% and 41.6% , 31.2% (χ2 = 3.892, p = 0.049), respectively. The 1- and 2-year overall survival rates (OS) of CRT and RT were 50.8% , 37.9% and 40.4% , 16.5% (χ2 = 1.811, p = 0.178), respectively. The major side effects were myelosuppression and digestive toxicities, but no differences were observed between the two groups. Compared with radiotherapy alone, whole-brain irradiation plus 3-D conformal boost irradiation and concurrent topotecan chemotherapy significantly improved the PFS rate and the intracranial lesion control rate of patients with brain metastases from lung cancer, and no significant increases in side effects were observed. Based on these results, this treatment method is recommended for phase III clinical trial.
ISSN:1748-717X
1748-717X
DOI:10.1186/1748-717X-8-238