[Radiation treatment of metastatic tumor in the brain]

Sixty-seven patients with metastatic tumor in the brain were seen from 1975 to Oct. 1985. 11 of the 22 untreated patients were followed to their death, the median survival was 2.9 months. The other 45 patients were all treated by irradiation. 40(89%) patients had bronchogenic carcinoma, three had primaries in other parts of the body and two had unknown primaries. In 16 patients, whole brain was irradiated to a dose of 1000-4000 cGy. Their 6 month survival rate was 25% but all died within one year. In 24 patients, whole brain was first irradiated to 3000-4000 cGy. Then the dose was increased to 5000-6000 cGy by cone down technique. Their 6 month survival was 75%, 1 year survival 33%. The high-dose-cone down method is obviously more effective. In the other 5 patients who were retreated locally for recurrence or new foci in the other parts of the brain, their survival was 4 to 8 months taken from the start of the second course of radiotherapy. One of these five patients is still living as of this writing. Extensive brain necrosis was observed in three patients who received whole brain radiation in the second course. Yet untoward reactions were noted in the two patients who received local irradiation in the second course. This may imply that, for the second course, only local radiation is indicated.