Radiotherapy of brain metastases from carcinoma of the bronchus

A retrospective study of 68 patients suffering from carcinoma of the bronchus with brain metastases is presented. They were treated in the Radiotherapy Department, Queen Elizabeth Hospital over a 5-year period (1982 to 1986). There were 42 male and 26 female patients. The age range was 30 to 78 years (median 58.5). All patients were treated with whole-brain photon irradiation using lateral opposing fields. The dosage could be divided into two groups: 30 Gy given in 10 to 15 daily fractions (30 patients), or 22.5 Gy given in five daily fractions (38 patients). There was no significant difference in the actuarial survival of the two groups (P = 0.37), the median survival being 7 and 6 weeks respectively. There was no difference in survival between the groups with different histological subtypes (P = 0.43). The 5-day short fractionation is the preferred treatment as it gives patients more time away from hospital. In 80.4% of patients there was progression of neurological symptoms before death. Increasing the dose of radiotherapy to the main bulk of tumour may improve the symptom-free survival or overall survival.