ABSTRACT
Objective To assess the feasibility and outcomes of fractionated stereotactice radiation therapy(FSRT) for brain metastases more than 3 cm in diameter. Methods From September 1996 to July 2006,47 patients(34 male and 13 female)with brain metastases larger than 3 cm were treated with FSRT. The median age was 58(range,31-87) years old. Pathologic diagnosis was adenocarcinoma in 19 patients, squamacarcinoma in 7, small cell carcinoma in 7, adeno-squamacarcinoma in 3, melanoma in 2, poor differen-tiated carcinoma, clear cell carcinoma, transitional cell carcinoma each in 1, and unknown in 6. FSRT was delivered as initial treatment for 26 patients, and as salvage therapy for 21. The largest diameter of brain me-tastases was 3.1-6.0 cm(median, 3.8 cm). Planning target volume were 2.5-33.8 cm3(median, 9.4 cm3). The median dose of FSRT was 30(range,16-57)Gy in 5(range,2 - 11) fractions. The treatment for primary tumor was surgery in 23 patients, radiotherapy and/or chemotherapy in 22, and none in 2. Results The last follow up was in April 2008. All patients were followed up and 33 had follow up more than 5 years. The 1-,2- and 5-year local control rate was 49%, 44% and 44%, respectively. The median survival time was 11 months(range,0.5-88.0 months, 95% CI=8.1-13.8 months). The corresponding overall survival rate was 40%, 17% and 6%, respectively. There were 46 patients died by the last follow up,including 21 died from brain metastases, 17 died from extracranial progression, and 8 died from other causes. Conclusion FSRT is safe and beneficial for selected patients with brain metastases larger than 3 cm.