What factors do you consider when selecting dose/fractionation for whole brain radiotherapy?
In which situations would you consider 37.5 Gy / 15 fx or 20 Gy / 5 fx over 30 Gy / 10 fx?
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What factors do you most heavily weigh when selecting WBRT dose/fractionation? (select all that apply)
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1 Answer
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Radiation Oncology · Columbia University Irving Medical Center
Answered on · Updated on
I assume this question is for brain metastases patients who are not eligible for hippocampal avoidance WBRT (ineligible criteria including but not limited to - mets 5 mm within either hippocampus, germ cell/small cell/lymphoma, leptomeningeal disease, etc.) - my default WBRT dose fractionation is 30 Gy in 10 fx.
I used to offer WBRT 37.5 Gy in 15 fx with memantine as per RTOG 0614 (PMID 23956241) but have stopped offering that as NRG CC001 used 30 Gy in 10 fx WBRT vs HA-WBRT (PMID 32058845). Also...
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