Effects of whole-brain radiotherapy, stereotactic ablation radiotherapy, and combined radiotherapy on brain metastases

To investigate the effects of different radiotherapy regimens on the prognosis of patients with brain metastases.

Patients with brain metastases undergoing radiotherapy from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into a whole-brain radiotherapy (WBRT) group, stereotactic ablative radiotherapy (SABR) group, and WBRT+SABR group, and overall survival (OS) and progression-free survival (PFS) were analyzed.

Forty patients were candidates for the analysis, with a median age of 57.5 years and a median follow-up time of 27.4 months. The median OS and PFS were 35.7 and 13.5 months, respectively, and the median radiotherapy dose was 41.7 Gy. The median OS times for patients who received WBRT (n = 12), SABR (n = 21), and WBRT+SABR (n = 7) were 41.8, 70.6, and 56.8 months, respectively (p = 0.7). The median PFS times were 10.2 months, 34.3 months, and 25.9 months, respectively (p = 0.322). Subgroup analysis indicated that the OS times were 25.4 months after WBRT (n = 7), 79.1 months after SABR (n = 11), and 65.9 months after WBRT+SABR (n = 5) among patients with brain metastases from lung cancer (p = 0.028). The patients had PFS times of 7.1, 33.4, and 29.1 months after irradiation with WBRT, SABR, and combination therapy, respectively (p = 0.009).

The three different radiotherapy regimens had no significant effects on the prognosis of patients with brain metastases. SBAR was superior to WBRT and WBRT+SABR with respect to the prognosis of patients with brain metastases from lung cancer. The sample size of this retrospective study was small; therefore, larger, prospective studies are needed.