A Retrospective Analysis of Treatment and Prognosis in Brain Metastases

ABSTRACT

A retrospective analysis of brain metastasis with respect to the pathology, hydrocephalus, cause of death, survival time and therapeutic modality was carried out in 47 cases. The duration of survival after CNS metastasis far less depends on the primary tumor than the latent interval between the onset of first symptom from primary tumor and CNS metastasis dose. And death was attributable to the CNS metastases in at least 5.3% of these cases. Surgery and radiotherapy but chemotherapy were included in this study. Radiotherapy had significant effects on prolongation of survival. The surgery plus postoperative whole brain radiotherapy had the longest survivals than the other treatment modalities. The authors recommend guidelines for surgical resection, usually followed by radiotherapyin cases which have good general condition enough to tolerate general anesthesia without any acute general morbidness, (1) single surgically accessible brain metastasis, (2) an incapacitating or large metastasis even when the tumor is not solitary, (3) uncertain primary cancer, (4) posterior fossa, especially cerebellar hemispheric metastasis. It seems that the presence of metastasis else where in the body should not exclude the case as a surgical candidate.