Analysis Survival of Breast Cancer with Brain Metastases Treated with Different Fraction Whole Brain Radiotherapy Concomitant with Capecitabine

Introduction: Breast cancer is the second most frequent cancer worldwide. The main therapeutic modality for breast cancer with brain metastases is radiation. Whole Brain Radiotherapy (WBRT) is a treatment that provides moderate doses of radiotherapy to all brain tissue. Capecitabine was found to be effective for the treatment of breast cancer with metastases and its metabolites can cross the BBB in animal models.   Objective: This study aims to determine the response and survival of breast cancer patient with brain metastases treated with different fractionation WBRT combined with capecitabine administration.   Materials and methods: This is a prospective, randomized-blind cohort analytic study. Subjects were randomized into two groups by giving different fraction of WBRT (Group I WBRT 10x3Gy and Group II WBRT 20x2Gy) concomitant with capecitabine 850-1000mg/m2. OS was calculated from brain metastases diagnosis. Median follow-up was 5.6 months.   Results: A total of 22 breast cancer patients with brain metastases participated in this study. Group I obtained results of 5 (45.5%) out of 11 are responding to therapy and median OS was 4.4 months. Whereas in group II found 11 (100%) out of 11 patients responded to therapy and median OS was 9.4 months. The results of statistical analysis showed that there were significant differences of response between the two groups with p value= 0.012. The differences of survival of each group also statistically significant with p value=0.004   Conclusions: WBRT with 20x2Gy concomitant with Capecitabine gives a better response rate and OS.