ABSTRACT

Brain metastasis is one of the important causes of morbidity and mortality in cancer patients. One ap-proach for improving local control is applying agents such as cyclooxygenase-2 inhibitor (celecoxib) that enhance radiosensitivity. This study was aimed to evaluate the safety and efficacy of the celecoxib which is delivered con-comitant to whole brain radiotherapy in patients with unresectable brain metastasis.

Thirty patients with brain metastasis, who received whole brain radiotherapy (30 Gy in 10 fractions over 2 weeks) alone or with celecoxib (a dose of 400 mg/day) were evaluated prospectively. Seventeen of 30 patients were in the celecoxib+radiotherapy group compared to 13 patients who were in the radiotherapy only group. The radiological response, neurological and performance status with neurological and hematological toxicities were assessed at the 60th day following radiotherapy.

Mean tumor volume was reduced from 7.9 mm3 to 3.5 mm3 in the celecoxib+radiotherapy group. In the radiotherapy only group, we did not observe any changes in mean tumor volume (8.9 mm3) compared to pre-treatment values. The difference of mean tumor volumes between treatment groups was statistically significant (p=0.001). Moreover, objective response ratios were higher in the celecoxib and radiotherapy group (p=0.002). However, the addition of celecoxib to radiotherapy did not improve neurological and performance status signifi-cantly. No hematological and neurological toxicities were observed in patients.

Concomitant application of celecoxib with whole brain radiotherapy was found effective and safe in the treatment of brain metastasis. However, further studies are required to validate our results. (Gazi Med J 2012; 23: 70-6)