Radation therapy for brain metastases

Annals of Neurology - Tập 7 Số 6 - Trang 529-541 - 1980
J. Gregory Cairncross1, Jae Ho Kim1, Jerome B. Posner1
1Departments of Neurology and Radiation Therapy, Memorial Sloan-Kettering Cancer Center, and the Department of Neurology, Cornell University Medical College, New York, NY

Tóm tắt

AbstractWe treated 183 patients who had brain metastases with whole‐brain radiation therapy (RT) and adrenocortico‐ steroids utilizing a new high‐dose radiation protocol. Treatment produced neurological improvement in 135 patients (74%); there was no change in 37 (20%), and deterioration occurred i n l l (6%). Of those patients who improved, two‐thirds maintained neurological improvement for the remainder of their lives or for at least nine months, and one‐third relapsed. One‐third of those who relapsed improved again with steroids or further RT. Clinical improvement paralleled tumor regression on CT scan. Despite the clinical response, median survival was only twelve weeks; 24% lived six months and 8% lived one year. Death resulted from progressive brain disease in 16% of the patients. Two‐thirds of the patients died of advancing systemic disease in the setting of stable, improved neurological function. These data suggest that the majority of patients with brain metastases benefit from RT and that systemic cancer, not central nervous system disease, limits the length of life.

Từ khóa


Tài liệu tham khảo

10.3109/02841867409132651

Brady LW, 1979, Brain Metastasis

10.1212/WNL.29.9_Part_1.1195

10.1002/1097-0142(197606)37:6<2719::AID-CNCR2820370623>3.0.CO;2-Q

10.1002/1097-0142(195407)7:4<682::AID-CNCR2820070409>3.0.CO;2-S

10.1002/1097-0142(199005/06)14:3<577::AID-CNCR2820140318>3.0.CO;2-F

10.1016/S0140-6736(68)91919-3

10.1002/1097-0142(197411)34:5<1607::AID-CNCR2820340508>3.0.CO;2-N

Fowler JF, 1966, Current Topics in Radiation Research, 303

Galicich JH, 1961, Use of dexamethasone in the treatment of cerebral edema resulting from brain tumors and brain surgery, Am Pract Dig Treat, 12, 169

Galicich JH, 1961, Use of dexamethasone in treatment of cerebral edema associated with brain tumors, J. Lancet, 81, 46

Gilbert H, 1979, Brain Metastasis

10.1002/1097-0142(197203)29:3<701::AID-CNCR2820290324>3.0.CO;2-S

Hazra T, 1972, Management of cerebral metastases from bronchogenic carcinoma, Johns Hopkins Med J, 130, 377

Hendrickson FR, 1975, Radiatino therapy of metastatic tumors, Semin Oncol, 2, 43

10.1016/0360-3016(77)90024-4

10.1002/1097-0142(197007)26:1<138::AID-CNCR2820260117>3.0.CO;2-5

10.2214/ajr.111.2.334

10.1001/jama.237.25.2730

10.1148/119.2.439

10.1001/jama.1957.02970510039008

10.1016/S0039-6109(16)37308-X

10.1212/WNL.16.5.521

10.1001/archneur.1978.00500350058012

10.1002/1097-0142(197206)29:6<1477::AID-CNCR2820290610>3.0.CO;2-H

10.2214/ajr.111.2.329

10.1148/91.1.149

10.1259/0007-1285-46-547-529

Posner JB, 1974, Diagnosis and treatment of metastases to the brain, Clin Bull, 4, 47

10.1001/archneur.1975.00490540025002

Posner JB, 1977, Management of central nervous system metastases, Semin Oncol, 4, 81

Posner JB, 1978, Intracranial metastases from systemic cancer, Adv Neurol, 19, 579

10.1002/ana.410020511

10.1136/bmj.1.5322.15

10.1002/1097-0142(196503)18:3<298::AID-CNCR2820180306>3.0.CO;2-H

10.1001/archneur.1974.00490330025004

10.1002/1097-0142(197408)34:2<257::AID-CNCR2820340206>3.0.CO;2-6

Tulloh ME, 1977, A randomized trial of prophylactic whole brain irradiation in small cell carcinoma of lung, Proc Am Soc Clin Oncol, 18, 268

10.1212/WNL.23.2.121

10.1002/1097-0142(197410)34:4<1069::AID-CNCR2820340416>3.0.CO;2-4

Thông tin
Thông tin xuất bản

Annals of Neurology

Tập 7 Số 6

529-541

Thông tin tác giả