J Cancer 2018; 9(23):4477-4483. doi:10.7150/jca.26547

Research Paper

Feasibility and Efficacy of Simultaneous Integrated Boost Intensity-modulated Radiation Therapy based on MRI-CT fusion in Patients with Brain Metastases of Non-small Cell Lung Cancer

Yinping Dong1,3, Yanke Zhang2, Tianyi Zhang1, Min Fan3, Jian Zhu3, Baosheng Li3, Wei Huang3✉

1. School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China;
2. Department of Radiation Oncology, the General Hospital of Yan-zhou Mining Group, Jining, China;
3. Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China

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Citation:
Dong Y, Zhang Y, Zhang T, Fan M, Zhu J, Li B, Huang W. Feasibility and Efficacy of Simultaneous Integrated Boost Intensity-modulated Radiation Therapy based on MRI-CT fusion in Patients with Brain Metastases of Non-small Cell Lung Cancer. J Cancer 2018; 9(23):4477-4483. doi:10.7150/jca.26547. Available from http://www.jcancer.org/v09p4477.htm

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Abstract

Purpose: To assess the feasibility and therapeutic effects of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) based on the fusion imaging of magnetic resonance imaging (MRI) and computed tomography (CT) as a dose-intensive technique in patients with brain metastases (BM) of non-small cell lung cancer (NSCLC).

Methods and materials: Forty-six NSCLC patients with 1 to 7 brain metastases were enrolled in this retrospective study between November, 2011 and February, 2017. Thirty-one patients (67.4%) had 1-3 metastases (oligometastases), otherwise, more than 3 metastases were seen in only 15 patients (32.6%). GTV (Gross tumor volume) contouring was based on the fusion imaging of MRI-CT, WBRT was prescribed in 37.5 Gy/15 fractions with a simultaneous boost in the metastatic lesions of 52.5 Gy/15 fractions.

Results: The median overall survival (OS) and intracranial progression free survival (PFS) for all the patients were 20.0 months and 11.0 months, respectively. The 6-month and 1-year OS were 87.0% and 69.6% respectively, while the 6-month and 1-year PFS were 78.3% and 43.5% respectively. Until the end of the follow-up, 16 patients (34.8%) were alive. No evidence of intracranial progress or recurrence was found in 6 patients (13.0%) during the follow-up.

Conclusion: SIB-IMRT with the dose/fractionation based on the fusion imaging of MRI-CT is feasible and safe. It is beneficial to the NSCLC patients with BM and can reduce the overall costs of treatment.

Keywords: non-small cell lung cancer (NSCLC), simultaneous integrated boost (SIB), intensity-modulated radiation therapy (IMRT), brain metastases (BM), magnetic resonance imaging (MRI)