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ISRN Oncology
Volume 2013 (2013), Article ID 214304, 4 pages
http://dx.doi.org/10.1155/2013/214304
Clinical Study

Does Time between Imaging Diagnosis and Initiation of Radiotherapy Impact Survival after Whole-Brain Radiotherapy for Brain Metastases?

1Department of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodø, Norway
2Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, 9037 Tromsø, Norway
3Department of Oncology, University Hospital of Northern Norway, 9037 Tromsø, Norway

Received 26 February 2013; Accepted 29 March 2013

Academic Editors: R.-J. Bensadoun, J. Bentel, and B. Comin-Anduix

Copyright © 2013 Carsten Nieder et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aims. To evaluate whether reduced waiting time influences survival of patients treated with whole-brain radiotherapy (WBRT) for brain metastases. Materials and Methods. Retrospective intention-to-treat study including 110 patients treated with primary WBRT (typically 10 fractions of 3 Gy; no other treatment between diagnosis and WBRT). Uni- and multivariate tests were performed. Results. Median delay between imaging diagnosis and WBRT was 12 days (range 0–66 days). WBRT started within 1 week in 36%, during the second week in 28%, and during the third week in 18% of patients. No significant correlation between waiting time and survival was evident, except for one subgroup of patients. Those without extracranial metastases (potentially more threatened by worse intracranial disease control) survived for a median of 2.5 months from WBRT if waiting time was 2 weeks or longer as compared to 5.6 months if waiting time was shorter than 2 weeks ( ). The same correlation was seen if survival was computed from imaging diagnosis. Conclusion. If departmental resources are not sufficient to provide immediate WBRT within 2 weeks to all patients, those without extracranial metastases should be prioritised. This study did not address the impact of waiting time on quality of life or symptom palliation.