TABLE II
Studies of whole-brain altered-fractionation radiotherapy for brain metastases
| Reference | Study arms | Patients (n) | Survival | |
|---|---|---|---|---|
| Median (range) | Overall at 6 mo. [n (%)] | |||
| Bach et al., 1996 | 50.4 Gy/28 fractions, 5 fractions/week | 44 | 160 days (74–2021 days) a | |
| 22 Gy/4 fractions | 57 | 88 days | ||
| sclc patients post-chemotherapy | (p<0.00001) | (20–948 days), | ||
| Borgelt et al., | Study 1: | |||
| 1980 | 30 Gy/10 fractions | 233 | 4.2 months | |
| 30 Gy/15 fractions | 217 | (3.7–4.6 months) | ||
| 40 Gy/15 fractions | 233 | (p>0.05) | ||
| 40 Gy/20 fractions | 227 | |||
| Study 2: | ||||
| 20 Gy/5 fractions | 447 | 3.5 months | ||
| 30 Gy/10 fractions | 228 | (3.2–3.5 months) | ||
| 40 Gy/15 fractions | 227 | (p>0.05) | ||
| Borgelt et al., 1981 | Study 1: | |||
| 10 Gy/1 fractions | 26 | 3.5 months | ||
| 30–40 Gy/10–20 fractions | 112 | 4.8 months (p>0.05) | ||
| Study 2: | ||||
| 12 Gy/2 fractions | 33 | 3.0 months | ||
| 20 Gy/5 fractions | 31 | 2.8 months (p>0.05) | ||
| Chatani et al., 1994 (abstract) | Normal lactate dehydrogenase (ldh): | |||
| 30 Gy/10 fractions | 46 | 5.4 months | 19 (41) | |
| 50 Gy/20 fractions | 46 | 4.8 months (p=0.841) | 22 (48) | |
| High ldh | ||||
| 30 Gy/10 fractions | 35 | 3.4 months | 7 (20) | |
| 50 Gy/20 fractions | 35 | 2.4 months (p=0.943) | 7 (20) | |
| Gelber et al., 1981 | 20 Gy/5 fractions | Breast patients: 160 | 33 weeks | |
| 30 Gy/10 fractions | Lung patients: 556 | 20 weeks | ||
| 30 Gy/15 fractions | Other patients: 213 | 20 weeks | ||
| 40 Gy/15 fractions | ||||
| 40 Gy/20 fractions | ||||
| Haie–Meder et al., 1993 | 1 course: | |||
| 18 Gy/3 fractions/3 days | 110 | 4.2 months | 53 (48) | |
| 2 courses: | (p>0.05) | |||
| 18 Gy/3 fractions/3 days followed 1 month later by another 18 Gy/3 fractions/3 days, or 18 Gy/3 fractions/3 days followed 1 month later by another 25 Gy/10 fractions/14 days | 106 | 5.3 months | 41 (38) | |
| Harwood et al., 1977 | 10 Gy/1 fractions | 51 | 4.4 months (p=0.082) | 14 (27) |
| 30 Gy/10 fractions | 50 | 4.0 months | 20 (40) | |
| Kurtz et al., 1981 | 30 Gy/10 fractions | 130 | 18 weeks (p = ns) | |
| 50 Gy/20 fractions | 125 | 17 weeks | ||
| Murray et al., 1997 | 54.4 Gy/34 fractions bid (over 17 days) | 216 | 4.5 months (p=0.52) | 84 (39) |
| 30 Gy/10 fractions (over 10 days) | 213 | 4.5 months | 88 (41) | |
| Nieder et al., 1997 | 30 Gy/12 fractions bid + surgery | 11 | 3.3 months | |
| 30 Gy/12 fractions bid | 36 | 2.0 months | ||
| 50.4 Gy/28 fractions bid | 15 | 2.0 months | ||
| 30 Gy/10 fractions (historical group) | 246 | 2.5 months | ||
| 30 Gy/10 fractions + surgery (historical group) | 37 | 7.3 months | ||
| Portaluri et al., 2004 | 50 Gy/25 fractions | 26 | 4 months (mean survival) | 6 (21) |
| 30 Gy/10 fractions | 48 | 5 months | 18 (36) | |
| 20 Gy/5 fractions | 42 | 5 months | 9 (21) | |
| 9 Unusual fractionation treatments b | ||||
| Priestman et al., 1996 | 30 Gy/10 fractions | 263 | 2.8 months (p=0.04) | 46 (17) |
| 12 Gy/2 fractions | 270 | 2.5 months | 66 (25) | |