[Results of radiotherapy in brain metastasis].

Abstract

Purpose: To evaluate the effect of radiation therapy in the treatment of brain metastases.

Patients and methods: Fifty-eight patients with brain metastases were irradiated. In 52 patients the post-therapeutic survival time could be evaluated. Most frequent basic tumor entity was lung cancer, followed by breast cancer. Eighteen patients underwent neurosurgery prior to radiation therapy, 23 patients underwent only radiotherapy and in 13 patients an additional chemotherapy was performed. Four patients were treated by all these means. Radiation therapy was done as a whole brain irradiation with a total dose of 40 Gy at single doses of two Gy or 30 Gy at single doses of 3 Gy respectively.

Results: There were no radiogenic complications. 42 of 58 patients (72%) showed an improved neurological status. In ten patients radiation therapy had to be abandoned due to deterioration of the patients condition, five patients died in the hospital. Mean survival time for all the patients were 213 days, by subtracting the preterminally treated patients the time improved up to 269 days. The prognosis was dependant of several factors. Main importance had the basic tumor entity itself leading to a mean survival time in breast cancer patients of 347 days in contrary to those with lung cancer and 152 days mean survival time. Good general status, young age and solitary metastasis were positive predictive factors.

Conclusions: Radiation therapy is capable to improve quality of life and to prolong survival after an only short treatment period. Treatment should be initiated quickly and consequently after diagnosis.