[Results of radiation therapy in brain metastases with reference to computerized tomography]

Between 1979 and 1985, 193 patients were submitted to radiotherapy of the brain for formation of metastases. A primary irradiation was performed in 159 patients, 34 patients had been treated by surgery. The median survival time after diagnosis of all irradiated patients (40 to 60 Gy within four to six weeks) was 4.9 months, 22% of the patients survived one year. Patients with mammary carcinomas and patients with bronchial carcinomas showed marked differences in median survival times (4.2 and 6.9 months, respectively) and one-year survival rate (11% and 32%, respectively). In histologic examination, the extent of extracerebral formation of metastases was the decisive parameter for survival. At the end of radiotherapy, 47% of patients showed an amelioration in neurologic deficiency, 16% deteriorated. A follow-up by computed tomography with observation periods between four and 34 months was possible in 84 patients. Most of these patients showed improvement in computed tomography during a period of four to twenty weeks after the beginning of radiotherapy. Later on, about two thirds of the controlled patients had again deterioration with local progression or new formation of metastases in spite of total brain irradiation. A long-term normalization (greater than one year) was observed only in patients with mammary carcinomas.