Radiotherapy for brain metastases in southern Thailand: workload, treatment pattern and survival.

Abstract

PURPOSE:

To study the patient load, treatment pattern, survival outcome and its predictors in patients with brain metastases treated by radiotherapy.

MATERIALS AND METHODS:

Data for patients with brain metastases treated by radiotherapy between 2003 and 2007 were collected from medical records, the hospital information system database, and a population-based tumor registry database until death or at least 5 years after treatment and retrospectively reviewed.

RESULTS:

The number of treatments for brain metastases gradually increased from 48 in 2003 to 107 in 2007, with more than 70% from lung and breast cancers. The majority were treated with whole brain radiation of 30 Gy (3 Gy X 10 fractions) by cobalt-60 machine, using radiation alone. The overall median survival of the 418 patients was 3.9 months. Cohort analysis of relative survival after radiotherapy was as follows: 52% at 3 months, 18% at 1 year and 3% at 5 years in males; and 66% at 3 months, 26% at 1 year and 7% at 5 years in females. Multivariate analysis demonstrated that the patients treated with combined modalities had a better prognosis. Poor prognostic factors included primary cancer from the lung or gastrointestinal tract, emergency or urgent consultation, poor performance status (ECOG 3-4), and a hemoglobin level before treatment of less than 10 g/dl.

CONCLUSIONS:

This study identified an increasing trend of patient load with brain metastases. Possible over-treatment and under-treatment were demonstrated with a wide range of survival results. Practical prognostic scoring systems to assist in decision-making for optimal treatment of different patient groups is absolutely necessary; it is a key strategy for balancing good quality of care and patient load.

• Authors: Temsak Phungrassami, Hutcha Sriplung
• Journal: Asian Pacific journal of cancer prevention : APJCP (Asian Pac J Cancer Prev) Vol. 16 Issue 4 Pg. 1435-42 ( 2015) ISSN: 2476-762X [Electronic] Thailand
• PMID: 25743812 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Brain Neoplasms (mortality, radiotherapy, secondary)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Neoplasms (mortality, pathology, radiotherapy)
• Prognosis
• Radiotherapy (mortality)
• Retrospective Studies
• Survival Rate
• Thailand
• Workload