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J Korean Soc Ther Radiol Oncol > Volume 17(4); 1999 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 1999;17(4): 281-286.
The Role of Radiotherapy in Patients with Brain Metastasis
Soon Nam Lee, Mi Soon Choo, Kyung Ja Lee, Eunmi Nam
1Department of Internal Medicine, College of Medicine, Ewha Womans University, Korea.
2Department of Radiation Oncology, College of Medicine, Ewha Womans University, Korea.
3Department of Internal Medicine, College of Medicine, Sung Kyun Kwan University, Samsung Medical Center, Korea.
Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases.
Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were analysed according to several factors such as age, performance status, primary malignancies, the presence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method.
Frequent symptoms associated with brain metastasis were headache (47.9%), motor weakness (40.8%), nausea and vomiting (19.7%) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9% of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0% and 5.1% respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438).
Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.
Key Words: Brain metastases, Radiation therapy, Prognostic factors
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