Faculty Collaboration Database

Safety and feasibility of motexafin gadolinium administration with whole brain radiation therapy and stereotactic radiosurgery boost in the treatment of ≤ 6 brain metastases: a multi-institutional phase II trial. J Neurooncol 2011 Nov;105(2):301-8

Date

04/28/2011

Pubmed ID

21523486

DOI

10.1007/s11060-011-0590-9

Scopus ID

2-s2.0-82955233755 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

To determine the safety, tolerability, and report on secondary efficacy endpoints of motexafin gadolinium (MGd) in combination with whole-brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS) for patients with ≤ 6 brain metastases. We conducted an international study of WBRT (37.5 Gy in 15 fractions) and SRS (15-21 Gy) with the addition of MGd (5 mg/kg preceding each fraction beginning week 2). The primary endpoint was to evaluate the rate of irreversible grade 3 or any grade ≥ 4 neurotoxicity and establish feasibility in preparation for a phase III trial. Sixty-five patients were enrolled from 14 institutions, of which 45 (69%) received SRS with MGd as intended and were available for evaluation. Grade ≥ 3 neurotoxicity attributable to radiation therapy within 3 months of SRS was seen in 2 patients (4.4%), including generalized weakness and radionecrosis requiring surgical management. Immediately following the course of MGd plus WBRT, new brain metastases were detected in 11 patients (24.4%) at the time of the SRS treatment planning MRI. The actuarial incidence of neurologic progression at 6 months and 1 year was 17 and 20%, respectively. The median investigator-determined neurologic progression free survival and overall survival times were 8 (95% CI: 5-14) and 9 months (95% CI: 6-not reached), respectively. We observed a low rate of neurotoxicity, demonstrating that the addition of MGd does not increase the incidence or severity of neurologic complications from WBRT with SRS boost.

Author List

McHaffie DR, Chabot P, Dagnault A, Suh JH, Fortin MA, Chang E, Timmerman R, Souhami L, Grecula J, Nabid A, Schultz C, Werner-Wasik M, Gaspar LE, Brachman D, Mody T, Mehta MP

Author

Christopher J. Schultz MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Agents
Brain Neoplasms
Combined Modality Therapy
Cranial Irradiation
Feasibility Studies
Female
Follow-Up Studies
Humans
International Agencies
Male
Metalloporphyrins
Middle Aged
Neoplasm Recurrence, Local
Neoplasms
Radiosurgery
Survival Rate
Treatment Outcome