Clinical observation of stereotactic radiosurgery combined with whole brain radiotherapy and fotemustine for brain metastases

Objective: This work aims to investigate the short-term effect, toxicity, and disease-free survival time of stereotactic radiosurgery (SRS) combined with whole brain radiation therapy (WBRT) and fotemustine in brain metastases. Methods: A total of 72 cases with brain metastases were randomized into the SRS and simple WBRT groups. Fotemustine (2 mg/kg) was administered intravenously on days 1, 8, and 15. Results: The overall response rate was significantly higher in the SRS group (91.7%) than in the WBRT group (72.2%; P < 0.05). The median disease-free survival time to cerebral progression in the SRS and WBRT groups were 9.0 and 7.0 months, respectively (P < 0.05). The central nervous system toxicity was milder in the SRS group than that in the WBRT group. Systemic toxicity of the two groups was primarily hematologic toxicity that was tolerated by most patients. Conclusions: SRS with WBRT and fotemustine is a feasible therapeutic option for patients with brain metastases. This therapy can improve the clinical response rate and median survival time to cerebral progression of the disease.