[Concentrated radiotherapy of brain metastases]

Presentation of 60 patients with cerebral metastases irradiated with a telecobaltotherapy machine (concentrated high dose treatment) from 1976 to 1979; 47 patients fully completed the treatment: 11 patients had only one part of the concentrated treatment and 36 patients had both parts of the concentrated treatment. Of the 11 patients who received only one part of the concentrated high dose treatment (3 x 650 rads mid-line dose to the whole brain during 3 consecutive days and then, after a rest period of 3 weeks, 12 x 170 rads mid-line dose given in two weeks using classical fractionation, total dose 3990 rads), 9 (81.8%) responded favourably with average survival of 5 months. Of the 36 patients who received both parts of the concentrated high dose treatment, i.e. 3 x 650 rads mid-line dose in 3 consecutive days and then the same treatment repeated 3 weeks later. giving a total dose of 3900 rads, 31 (86.1%) responded favourably with an average survival of 5 months. This type of regimen, using the two-part concentrated high dose treatment ("split course therapy"), not only spectacularly alleviated neurological signs and symptoms but had the added advantage of appreciably reducing the patients' stay in hospital.