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