Document Detail

Distribution of brain metastases: implications for non-uniform dose prescriptions.
MedLine Citation:
PMID:  21697413     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this study was to determine the disease-specific distribution of brain metastases and, using radiobiological modelling, estimate how these anatomical tendencies might be exploited when delivering prophylactic whole-brain radiotherapy for small cell lung cancer in complete remission.
METHODS: Disease-specific brain metastasis atlases were created by mapping brain metastases to a standard image set from a database of patients who were to receive external beam radiation therapy. The specific diseases investigated included lung (both small cell and non-small cell), breast, renal and gynaecological cancers as well as melanoma. Radiobiological modelling was used to estimate how much improvement, in terms of the metastasis-free rate at 3 years, might be possible with non-uniform dose distributions if there are spatial biases in the incidence of micrometastases from small cell lung cancer.
RESULTS: For lung and breast cancer, there was an increased probability of cerebellar metastases compared with what would be predicted based solely on brain volume. This trend was not evident for renal cancer, gynaecological malignancies or melanoma.
CONCLUSION: Radiobiological models suggest that if there is a non-uniform distribution of microscopic brain metastases in patients with small cell lung cancer, higher population-based metastasis-free rates might be achievable with non-uniform irradiation compared with the same integral whole-brain dose delivered as a uniform prescription.
E T Bender; W A Tomé
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The British journal of radiology     Volume:  84     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-23     Completed Date:  2011-08-22     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  649-58     Citation Subset:  AIM; IM    
Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, 53792, USA.
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MeSH Terms
Brain Neoplasms / pathology,  radiotherapy,  secondary*
Carcinoma, Non-Small-Cell Lung / radiotherapy,  secondary*
Lung Neoplasms / pathology*,  radiotherapy
Models, Biological
Radiotherapy Dosage
Remission Induction
Survival Analysis
Treatment Outcome
Grant Support
R01-CA109656/CA/NCI NIH HHS; R01-CA118365/CA/NCI NIH HHS; T32-CA09206-31/CA/NCI NIH HHS

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