Tesis

Perbedaan Luaran Klinis Pada Pasien Metastasis Otak yang dilakukan Whole Brain Radiation Therapy dengan atau tanpa Simultaneous Integrated Boost = Clinical Outcomes of Whole Brain Radiation Therapy with or without Simultaneous Integrated Boost in Brain Metastases Patients.

Tujuan: membandingkan perbedaan luaran klinis antara pasien metastasis otak yang diberikan whole brain radiation therapy (WBRT) dan WBRT dengan simultaneous integrated boost (SIB) pada pasien metastasis otak. Metode: antara tahun Januari 2018 dan Januari 2023, 47 pasien metastasis otak diberikan radioterapi paliatif otak. Diantaranya, 30 pasien menjalani WBRT dan 17 pasien menjalani WBRT-SIB. Hasil akhir pada penelitian ini termasuk kontrol intrakranial, respons tumor dan kesintasan keseluruhan (OS). Hasil: median follow-up pada kelompok WBRT dan WBRT-SIB yaitu 5,4 bulan dan 7,1 bulan secara berurutan. Median kontrol intrakranial pada kelompok WBRT adalah 4,8 bulan dan 9 bulan pada kelompok WBRT-SIB. Kontrol intrakranial 6 bulan pada kelompok WBRT-SIB lebih tinggi dibandingkan kelompok WBRT (76,4% vs 30%, p=0,002). Tidak terdapat perbedaan signifikan pada kesintasan keseluruhan dan respons tumor. Analisis multivariat menunjukkan Penyakit primer terkontrol, kemoterapi pasca RT dan metode WBRT-SIB dapat meningkatkan angka kontrol intrakranial pada pasien metastasis otak. Tidak dijumpai toksisitas radiasi derajat 3 atau lebih pada kedua kelompok. Tidak terdapat perbedaan signifkan penurunan fungsi kognitif pada kedua kelompok. Kesimpulan: WBRT-SIB dapat meningkatkan kontrol intrakranial dibandingkan WBRT saja pada pasien metastasis otak. Namun, tidak dijumpai perbedaan signifikan OS dan respons tumor pada kedua kelompok.
Kata kunci: metastasis otak, whole brain radiation therapy, simultaneous integrated boost, kontrol intrakranial


Purpose: To compare the differences in clinical outcomes between brain metastasis patients treated with Whole Brain Radiation Therapy (WBRT) alone and WBRT with Simultaneous Integrated Boost (SIB). Method: Between January 2018 and January 2023, 47 brain metastasis patients received palliative brain radiotherapy. Among them, 30 patients underwent WBRT, and 17 patients underwent WBRT-SIB. The primary outcomes assessed in this study included intracranial control, tumor response, and overall survival (OS). Results: The median follow-up in the WBRT and WBRT-SIB groups was 5.4 months and 7.1 months, respectively. The median intracranial control in the WBRT group was 4.8 months, while in the WBRT-SIB group was 9 months. The 6-month intracranial control in the WBRT-SIB group was significantly higher compared to the WBRT group (76.4% vs. 30%, p=0.002). There were no significant differences in overall survival and tumor response between the two groups. Multivariate analysis showed that controlled primary disease, post-RT chemotherapy, and WBRT-SIB method could improve intracranial control rates in brain metastasis patients. No grade 3 or higher radiation toxicity was observed in both groups. There were no significant differences in cognitive function decline between the two groups. Conclusion: WBRT-SIB can improve intracranial control compared to WBRT alone in brain metastasis patients. However, there were no significant differences in overall survival and tumor response between the two groups.
Keywords: brain metastasis, whole brain radiation therapy, simultaneous integrated boost, intracranial control.