Clinical evaluation of simultaneous integrated boost in brain metastasis patients with helical intensity modulated radiotherapy

Background: this study was performed to assess patient survival and treatmenttoxicity atier helical tomotherapy (ht) with simultaneous integrated boost (sib)radiotherapy (rt) for cancer patients with one to eight brain metastases (bm) whohave been treated with or without surgery. materials and methods: a total of 48brain metastasis (bm) patients were included in this retrospective study betweenapril 2015 and december 2016,. the patients were treated with image-guidedintensity modulated radiation therapy (imrt) on the helical tomotherapy (ht)machine. whole brain ht as 25 gy and sib to metastasis sites as 35 gy wasdelivered in 10 fractions. the patient were aged between 50 to 80 years old,volume of the bm was between 6 to 75 cc and the number of brain metastasis wasbetween 1 to 8, karnofsky performance score (kps) ranged between 50-90 and rpai-iii. surgery was performed to two patients before rt. the maximum patient follow-up time was 20 months. results: the primary neurotoxicity observed inpatients was grade i- ii brain edema related headache and lethargy. inpatients who had survived 3- 12 months, kps improved median score of 20points and rpa was grade i atier six months. twelve patients had passedaway at the end of a 20- month follow-up. conclusion: ht utilizing sibtreatment for 1- 8 bm was achieved successfully with no significant toxicity. animprovement of performance status indicators of patients following rt was observed.