Distribution of brain metastases: Implications for non-uniform dose prescriptions

Edward T. Bender, Wolfgang A. Tome

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)649-658
Number of pages10
JournalBritish Journal of Radiology
Volume84
Issue number1003
DOIs
StatePublished - Jul 2011
Externally publishedYes

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Prescriptions
Neoplasm Metastasis
Brain
Small Cell Lung Carcinoma
Kidney Neoplasms
Melanoma
Radiotherapy
Brain Mapping
Neoplasm Micrometastasis
Atlases
Brain Diseases
Lung Neoplasms
Breast
Databases
Breast Neoplasms
Lung
Incidence
Population
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Distribution of brain metastases : Implications for non-uniform dose prescriptions. / Bender, Edward T.; Tome, Wolfgang A.

In: British Journal of Radiology, Vol. 84, No. 1003, 07.2011, p. 649-658.

Research output: Contribution to journalArticle

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