Comparison of 20×2 Gy and 12×3 Gy for Whole-brain Irradiation of Multiple Brain Metastases from Malignant Melanoma

BACKGROUND/AIM: Most patients with multiple brain metastases from melanoma receive whole-brain irradiation. In a previous study, doses >30 Gy resulted in better outcomes than 10×3 Gy. However, the optimal dose-fractionation regimen has not yet been defined. This study compared 20×2 Gy over four weeks, which was used in the previous study, to 12×3 Gy over two-and-a-half weeks.

PATIENTS AND METHODS: Eleven patients treated with 20×2 Gy for multiple brain metastases were compared to 12 patients treated with 12×3 Gy.

RESULTS: Intracerebral control rates at 6 and 12 months were 17% and 0% after 20×2 Gy vs. 42% and 11% after 12×3 Gy (p=0.28). Survival rates at 6 and 12 months were 36% and 9% after 20×2 Gy vs. 50% and 25% after 12×3 Gy (p=0.75).

CONCLUSION: The less time-consuming regimen 12x3 Gy appeared not inferior to 20×2 Gy and a reasonable treatment option, particularly for patients with a limited life expectancy.