Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases

Md Ruhul Amin Bhuiyan; Farhana Hussain Sadia; Ahammad Al Mamun Sweet; Md Ershadul Haque; Khandaker Md. Rezwan Bayzid; AZM Sumsuzoha; Aditi Paul Chowdhury; Md Abdul Mannan

doi:doi:10.11648/j.ijcocr.20240901.11

Research Article |

Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases

Md Ruhul Amin Bhuiyan^*, Farhana Hussain Sadia, Ahammad Al Mamun Sweet, Md Ershadul Haque, Khandaker Md. Rezwan Bayzid, AZM Sumsuzoha, Aditi Paul Chowdhury, Md Abdul Mannan

Published in International Journal of Clinical Oncology and Cancer Research (Volume 9, Issue 1)

Received: 10 April 2023 Accepted: 10 June 2023 Published: 8 January 2024

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Abstract

Background: Brain metastases are secondary tumors that develop from primary malignant tumors located outside the central nervous system. It is the most common kind of intracranial tumor in adults. Brain metastases are treated with both decisive anticancer therapy and supportive care. Objective: To compare the efficacy of whole brain radiotherapy versus concurrent whole brain radiotherapy with Temozolomide in the treatment of brain metastases. Method: This quasi-experimental study was conducted in the department of Oncology in Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajganj among 68 patients from December 2018 to June 2020. Patients who attended the KYAMCH Oncology department during the study period and met the selection criteria were enrolled in the study. Results: In Arm A, the mean age was 56.15±10.14 years and in Arm B, the mean age was 54.06±10.24 years. Karnofsky Performance Status of most of the patients was 70 or above in both arms, which was 25 (73.50%) and 26 (76.50%) in Arm A and Arm B respectively. In Arm A, the most common primary tumor site was lung 17 (50%) and in Arm B, it was lung 18 (52.94%). In Arm A, the most common clinical feature was headache 21 (61.80%) and In Arm B, 20 (58.80%) patients too presented with headache. In Arm A, before treatment 5 (14.70%) patients had convulsion. In Arm B, before treatment 6 (17.60%) patients had convulsion. After treatment convulsion was found in 2 (5.90%) patients. The response was more in Arm B. The most common non- hematological toxicity was nausea, which developed in 17 (50%) patients in Arm A and 22 (64.70%) patients in Arm B. Though non- hematological toxicities were more in Arm B, it was not statistically significant. Thrombocytopenia was reported in 11 (32.35%) patients in Arm A and 20 (58.82%). In Arm A, CR was observed in 02 (05.90%) patients and in Arm B, CR was observed in 05 (14.70%) patients. Statistically significant radiological responses were achieved in the WBRT+TMZ arm compared to the WBRT alone arm. Adenocarcinoma overall response was achieved in 6 (17.64%) patients in Arm A and 12 (35.29%) patients in Arm B. Conclusion: After analyzing the result of the study it can be concluded that the efficacy of concurrent radiotherapy with Temozolomide is higher than that of radiotherapy alone in the treatment of brain metastases. The combined treatment protocol significantly improves the symptoms and signs with acceptable toxicity profile.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 9, Issue 1)
DOI	10.11648/j.ijcocr.20240901.11
Page(s)	1-10
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Metastases, Radiotherapy, Temozolomide

References

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Bhuiyan, M. R. A., Sadia, F. H., Sweet, A. A. M., Haque, M. E., Bayzid, K. M. R., et al. (2024). Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases. International Journal of Clinical Oncology and Cancer Research, 9(1), 1-10. https://doi.org/10.11648/j.ijcocr.20240901.11

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Bhuiyan, M. R. A.; Sadia, F. H.; Sweet, A. A. M.; Haque, M. E.; Bayzid, K. M. R., et al. Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases. Int. J. Clin. Oncol. Cancer Res. 2024, 9(1), 1-10. doi: 10.11648/j.ijcocr.20240901.11

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Bhuiyan MRA, Sadia FH, Sweet AAM, Haque ME, Bayzid KMR, et al. Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases. Int J Clin Oncol Cancer Res. 2024;9(1):1-10. doi: 10.11648/j.ijcocr.20240901.11

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@article{10.11648/j.ijcocr.20240901.11,
  author = {Md Ruhul Amin Bhuiyan and Farhana Hussain Sadia and Ahammad Al Mamun Sweet and Md Ershadul Haque and Khandaker Md. Rezwan Bayzid and AZM Sumsuzoha and Aditi Paul Chowdhury and Md Abdul Mannan},
  title = {Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {9},
  number = {1},
  pages = {1-10},
  doi = {10.11648/j.ijcocr.20240901.11},
  url = {https://doi.org/10.11648/j.ijcocr.20240901.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20240901.11},
  abstract = {Background: Brain metastases are secondary tumors that develop from primary malignant tumors located outside the central nervous system. It is the most common kind of intracranial tumor in adults. Brain metastases are treated with both decisive anticancer therapy and supportive care. Objective: To compare the efficacy of whole brain radiotherapy versus concurrent whole brain radiotherapy with Temozolomide in the treatment of brain metastases. Method: This quasi-experimental study was conducted in the department of Oncology in Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajganj among 68 patients from December 2018 to June 2020. Patients who attended the KYAMCH Oncology department during the study period and met the selection criteria were enrolled in the study. Results: In Arm A, the mean age was 56.15±10.14 years and in Arm B, the mean age was 54.06±10.24 years. Karnofsky Performance Status of most of the patients was 70 or above in both arms, which was 25 (73.50%) and 26 (76.50%) in Arm A and Arm B respectively. In Arm A, the most common primary tumor site was lung 17 (50%) and in Arm B, it was lung 18 (52.94%). In Arm A, the most common clinical feature was headache 21 (61.80%) and In Arm B, 20 (58.80%) patients too presented with headache. In Arm A, before treatment 5 (14.70%) patients had convulsion. In Arm B, before treatment 6 (17.60%) patients had convulsion. After treatment convulsion was found in 2 (5.90%) patients. The response was more in Arm B. The most common non- hematological toxicity was nausea, which developed in 17 (50%) patients in Arm A and 22 (64.70%) patients in Arm B. Though non- hematological toxicities were more in Arm B, it was not statistically significant. Thrombocytopenia was reported in 11 (32.35%) patients in Arm A and 20 (58.82%). In Arm A, CR was observed in 02 (05.90%) patients and in Arm B, CR was observed in 05 (14.70%) patients. Statistically significant radiological responses were achieved in the WBRT+TMZ arm compared to the WBRT alone arm. Adenocarcinoma overall response was achieved in 6 (17.64%) patients in Arm A and 12 (35.29%) patients in Arm B. Conclusion: After analyzing the result of the study it can be concluded that the efficacy of concurrent radiotherapy with Temozolomide is higher than that of radiotherapy alone in the treatment of brain metastases. The combined treatment protocol significantly improves the symptoms and signs with acceptable toxicity profile.
},
 year = {2024}
}

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TY - JOUR
T1 - Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases
AU - Md Ruhul Amin Bhuiyan
AU - Farhana Hussain Sadia
AU - Ahammad Al Mamun Sweet
AU - Md Ershadul Haque
AU - Khandaker Md. Rezwan Bayzid
AU - AZM Sumsuzoha
AU - Aditi Paul Chowdhury
AU - Md Abdul Mannan
Y1 - 2024/01/08
PY - 2024
N1 - https://doi.org/10.11648/j.ijcocr.20240901.11
DO - 10.11648/j.ijcocr.20240901.11
T2 - International Journal of Clinical Oncology and Cancer Research
JF - International Journal of Clinical Oncology and Cancer Research
JO - International Journal of Clinical Oncology and Cancer Research
SP - 1
EP - 10
PB - Science Publishing Group
SN - 2578-9511
UR - https://doi.org/10.11648/j.ijcocr.20240901.11
AB - Background: Brain metastases are secondary tumors that develop from primary malignant tumors located outside the central nervous system. It is the most common kind of intracranial tumor in adults. Brain metastases are treated with both decisive anticancer therapy and supportive care. Objective: To compare the efficacy of whole brain radiotherapy versus concurrent whole brain radiotherapy with Temozolomide in the treatment of brain metastases. Method: This quasi-experimental study was conducted in the department of Oncology in Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajganj among 68 patients from December 2018 to June 2020. Patients who attended the KYAMCH Oncology department during the study period and met the selection criteria were enrolled in the study. Results: In Arm A, the mean age was 56.15±10.14 years and in Arm B, the mean age was 54.06±10.24 years. Karnofsky Performance Status of most of the patients was 70 or above in both arms, which was 25 (73.50%) and 26 (76.50%) in Arm A and Arm B respectively. In Arm A, the most common primary tumor site was lung 17 (50%) and in Arm B, it was lung 18 (52.94%). In Arm A, the most common clinical feature was headache 21 (61.80%) and In Arm B, 20 (58.80%) patients too presented with headache. In Arm A, before treatment 5 (14.70%) patients had convulsion. In Arm B, before treatment 6 (17.60%) patients had convulsion. After treatment convulsion was found in 2 (5.90%) patients. The response was more in Arm B. The most common non- hematological toxicity was nausea, which developed in 17 (50%) patients in Arm A and 22 (64.70%) patients in Arm B. Though non- hematological toxicities were more in Arm B, it was not statistically significant. Thrombocytopenia was reported in 11 (32.35%) patients in Arm A and 20 (58.82%). In Arm A, CR was observed in 02 (05.90%) patients and in Arm B, CR was observed in 05 (14.70%) patients. Statistically significant radiological responses were achieved in the WBRT+TMZ arm compared to the WBRT alone arm. Adenocarcinoma overall response was achieved in 6 (17.64%) patients in Arm A and 12 (35.29%) patients in Arm B. Conclusion: After analyzing the result of the study it can be concluded that the efficacy of concurrent radiotherapy with Temozolomide is higher than that of radiotherapy alone in the treatment of brain metastases. The combined treatment protocol significantly improves the symptoms and signs with acceptable toxicity profile.

VL - 9
IS - 1
ER -

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Author Information

Md Ruhul Amin Bhuiyan

Department of Oncology, North East Medical College & Hospital, Sylhet, Bangladesh

Contact Email
Farhana Hussain Sadia

Department of Physiology, Bangabandhu Medical College, Sunamganj, Sylhet, Bangladesh
Ahammad Al Mamun Sweet

Labaid Cancer Hospital and Super Speciality Centre, Dhaka, Bangladesh
Md Ershadul Haque

Department of Radiotherapy, Rangpur Medical College Hospital, Rangpur, Bangladesh
Khandaker Md. Rezwan Bayzid

Labaid Cancer Hospital and Super Speciality Centre, Dhaka, Bangladesh
AZM Sumsuzoha

Department of Oncology, TMSS Medical College & RCH, Bogura, Bangladesh
Aditi Paul Chowdhury

Department of Radiation Oncology, Ahsania mission cancer and General Hospital, Dhaka, Bangladesh
Md Abdul Mannan

Labaid Cancer Hospital and Super Speciality Centre, Dhaka, Bangladesh

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Bhuiyan, M. R. A., Sadia, F. H., Sweet, A. A. M., Haque, M. E., Bayzid, K. M. R., et al. (2024). Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases. International Journal of Clinical Oncology and Cancer Research, 9(1), 1-10. https://doi.org/10.11648/j.ijcocr.20240901.11

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Bhuiyan, M. R. A.; Sadia, F. H.; Sweet, A. A. M.; Haque, M. E.; Bayzid, K. M. R., et al. Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases. Int. J. Clin. Oncol. Cancer Res. 2024, 9(1), 1-10. doi: 10.11648/j.ijcocr.20240901.11

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Bhuiyan MRA, Sadia FH, Sweet AAM, Haque ME, Bayzid KMR, et al. Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases. Int J Clin Oncol Cancer Res. 2024;9(1):1-10. doi: 10.11648/j.ijcocr.20240901.11

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@article{10.11648/j.ijcocr.20240901.11,
  author = {Md Ruhul Amin Bhuiyan and Farhana Hussain Sadia and Ahammad Al Mamun Sweet and Md Ershadul Haque and Khandaker Md. Rezwan Bayzid and AZM Sumsuzoha and Aditi Paul Chowdhury and Md Abdul Mannan},
  title = {Comparative Study of Whole Brain Radiotherapy vs Whole Brain Radiotherapy with Concurrent Temozolomide in Brain Metastases},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {9},
  number = {1},
  pages = {1-10},
  doi = {10.11648/j.ijcocr.20240901.11},
  url = {https://doi.org/10.11648/j.ijcocr.20240901.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20240901.11},
  abstract = {Background: Brain metastases are secondary tumors that develop from primary malignant tumors located outside the central nervous system. It is the most common kind of intracranial tumor in adults. Brain metastases are treated with both decisive anticancer therapy and supportive care. Objective: To compare the efficacy of whole brain radiotherapy versus concurrent whole brain radiotherapy with Temozolomide in the treatment of brain metastases. Method: This quasi-experimental study was conducted in the department of Oncology in Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajganj among 68 patients from December 2018 to June 2020. Patients who attended the KYAMCH Oncology department during the study period and met the selection criteria were enrolled in the study. Results: In Arm A, the mean age was 56.15±10.14 years and in Arm B, the mean age was 54.06±10.24 years. Karnofsky Performance Status of most of the patients was 70 or above in both arms, which was 25 (73.50%) and 26 (76.50%) in Arm A and Arm B respectively. In Arm A, the most common primary tumor site was lung 17 (50%) and in Arm B, it was lung 18 (52.94%). In Arm A, the most common clinical feature was headache 21 (61.80%) and In Arm B, 20 (58.80%) patients too presented with headache. In Arm A, before treatment 5 (14.70%) patients had convulsion. In Arm B, before treatment 6 (17.60%) patients had convulsion. After treatment convulsion was found in 2 (5.90%) patients. The response was more in Arm B. The most common non- hematological toxicity was nausea, which developed in 17 (50%) patients in Arm A and 22 (64.70%) patients in Arm B. Though non- hematological toxicities were more in Arm B, it was not statistically significant. Thrombocytopenia was reported in 11 (32.35%) patients in Arm A and 20 (58.82%). In Arm A, CR was observed in 02 (05.90%) patients and in Arm B, CR was observed in 05 (14.70%) patients. Statistically significant radiological responses were achieved in the WBRT+TMZ arm compared to the WBRT alone arm. Adenocarcinoma overall response was achieved in 6 (17.64%) patients in Arm A and 12 (35.29%) patients in Arm B. Conclusion: After analyzing the result of the study it can be concluded that the efficacy of concurrent radiotherapy with Temozolomide is higher than that of radiotherapy alone in the treatment of brain metastases. The combined treatment protocol significantly improves the symptoms and signs with acceptable toxicity profile.
},
 year = {2024}
}

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VL - 9
IS - 1
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