Retrospective study of patients with brain metastases from melanoma receiving concurrent whole-brain radiation and temozolomide

Background: Metastatic melanoma is the second most common cancer to metastasize to the brain. It is typically treated using stereotactic radiosurgery with or without whole-brain radiation (WBR) therapy. Recently, the alkylating agent temozolomide, which has demonstrated activity in patients with brain metastasis and primary tumors, was used alongside WBR to delay brain metastasis recurrence, increase survival, and improve quality-of-life in patients with brain metastases. Patients and Methods: In this retrospective study, we reviewed outcomes of 29 patients treated from 2005-2009 at the Moffitt Cancer Center with brain metastases of melanoma. Results were narrowed via retrospective chart analysis to a cohort with brain metastasis receiving concomitant temozolomide and WBR. Results: Median progression-free survival was 20.4 weeks and overall survival was 44.4 weeks compared to 16 week survival of patients treated with WBR alone. Conclusion: A prospective trial evaluating this combined regimen may be considered.