Response of brain metastases to simulation whole brain and topotecan

Abstract

11560 Background: To see the response of topotecan with whole brain radiation with brain metastases. Methods: Prognosis of patients with brain metastases is poor when conventionally treated with whole brain radiation alone. Early studies have suggested that topotecan crosses the blood brain barrier and has synergistic cytotoxic with radiation. So we conducted a study at Oncology Department Combined Military Hospital Rawalpindi to determine the efficacy and toxicity of topotecan and whole brain radiation in patients with brain metastases. Results: Thirty patients with brain metastases received 2 mg/m2 topotecan once weekly for 2 weeks with concurrent whole brain radiation, 3,000 cGy, for 2 weeks. A complete response was observed in 2 (6.67 %) of the 30 eligible patients at the end of one month after completing radiation therapy, 14 (46.67 %) patients had a partial response, 10 (33.33 %) patients had stable disease while 4 (13.33 %) patients showed progressive disease. Adverse events of grade 3 or higher included 2 (6.67 %) cases each of neutropenia and vomiting. Other minor complications (grade 1/2) were nausea and vomiting in 12 (40 %) cases, constipation in 5 (6.67 %) cases, anemia in 10 (33.33 %) cases, neutropenia in 8 (26.67 %) cases, and mucositis in 6 (20 %). Conclusions: We concluded that topotecan as radiation sensitizer is well tolerated and effective for the treatment of brain metastases. No significant financial relationships to disclose.