Radiotherapy of brain metastases in lung cancer

Therapeutical approach in brain metastases still remains the major problem in many cancer patients, especially in those with primary lung lesion. The aim of the present study was to test the tolerance to a whole brain telegammatherapy with a daily dose of 2 Gy in patients with lung cancer, to evaluate the improvement of sensory and motor deficits, and to define the more appropriate total dose (20 or 30 Gy) with regard to the patient survival.

Thirty nine patients with lung cancer and verified brain metastases underwent a whole brain telegammatherapy to a total dose of 20-30 Gy. Solitary metastases were found in 45 percent of the patients but all were defined as inoperable cases. The other patients had two or more brain lesions.

All patients tolerated well the fraction and the total dose. The mean survival of the patients was 6.6 months with confidence interval 5.8-7.4 months. The survival difference between treatments with 20 and 30 Gy total dose did not reach statistical significance. Significant improvement was found in the Karnofsky index, intracranial pressure, headache, and neurologic symptoms after radiotherapy.

Radiation therapy in patients with brain metastases from lung cancer is well tolerated and improves the quality of life.