ArticleReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology2026
Whole brain radiotherapy and simultaneous integrated boost: is it still a viable treatment for multiple brain metastases in the era of SRS?
Article in Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The objective of this study was to determine the outcomes of whole brain radiotherapy (WBRT) + simultaneous integrated boost (SIB) treatment in patients with multiple brain metastases. Materials and methods: 34 patients who were treated for multiple brain metastases with WBRT + SIB in two radiation oncology departments between 2014 and 2020 were evaluated retrospectively. Intracranial control and overall survival after radiotherapy (RT) were calculated with the Kaplan-Meier test. The prognostic factors of survival after RT were determined with Cox regression analysis. Results: The median age was 62 [interquartile range (IQR): 57-69] years. Median survival after cranial RT was 10 [95% confidence interval (CI): 7-13] months. One-year intracranial control probability after RT was 83%. Acute and late RT toxicity were observed in 2 patients. After 3 months of follow-up, 23 (68%) patients had complete/near complete response, 9 (26%) had partial response, and 2 (6%) had stable disease. In univariate analysis, the factors affecting survival after cranial RT were the presence of neurological symptoms (p = 0.003) and Karnofsky performance score (KPS, p = 0.001). The median survival of patients with and without neurological symptoms was 5 (95% CI: 4-6) months and 16 (95% CI: 5-27) months. Median survival of patients with KPS 60, 70, 80, and 90 were 1, 5, 10 and 13 months, respectively. In multivariate analysis, the only statistically significant prognostic factor was KPS [hazard ratio (HR): 0.94 95% CI: (0.89-0.99), p = 0.031]. Conclusions: WBRT + SIB is a well-tolerated technique with a promising 1-year intracranial control rate of 83% for patients with multiple brain metastases who were not amenable to surgery and/or SRS, particularly in good performance status (KPS > 70) and without neurologic impairments.
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