[Radiotherapy of metastatic brain tumors]

In order to evaluate the role of radiotherapy cases of brain metastases, we retrospectively have analyzed the results of treatment in 89 patients with brain metastases, who had completed a course radiotherapy at the Jichi Medical School Hospital from August, 1973 to October, 1986. Cases analyzed included 60 patients with lung cancers, 6 with breast cancers, 6 with gastric cancers, 10 with other types, and 7 with unknown primary sites. The over-all median survival time was 4.7 months. Crude survival rates were 38.2% at 6 months, and 11.2% at one year, respectively. Two patients survived more than 3 years. The over-all rate of improvement of neurologic function (NF) were 75.3% of NF III patients, and 58% of NF II patients. There was, however, no significant difference in survival rates between the patients with and without NF improvement. Prognostic factors were investigated by a statistical method of a proportional hazard model. Age, the combined treatment with surgery and irradiation, and the neurologic standard dose (Neuret) were found to be factors which influenced the survival rate with a fair statistical significance. Survival rate increased with a decrease in age, an increase in the thoroughness of the surgical excision, and an increase in the Neuret dose. These data suggest that an aggressive approach to brain metastases in younger patients, so far as clinical judgements permit, may indeed improve survival.