Brain metastases: results and effects of re-irradiation.

摘要: Abstract Re-irradiation for recurrent manifestations of brain metastases has been reported to be benefit by either increasing the duration survival or improving quality life. The records 455 patients with treated radiation therapy at University Colorado Health Sciences Center from 1975 through 1986 were reviewed. Of these, 44 (9.7%) re-irradiated because suggestive neurological findings and/or imaging studies diagnostic disease. primary site distribution was as follows: lung (non-small cell)- 15 (34%), (small cell)-9 (20%), melanoma-5 (11%), breast-4 (9%), genitourinary-4 unknown-4 lymphoma-2 (4%), and endornetrium-1(2%). Retreated received least two courses irradiation one three. median interval between first second 34 weeks (7.8 months). For initial course treatment, all whole-brain megavoltage X rays a dose 30–36 Gy (median 30 Gy) 1.5 4.0 Gy/fraction 3.0 Gy/fraction). Retreatment also consisted (37/42 patients) additional doses 6–36 25 2.0 total cumulative brain, therefore, varied 38–75 60 Gy. Survival data available 42 retreated. All died overall following 40 (9.2 months) 10 (24%) living beyond 1 year. retreatment, however, only 8 patient surviving greater than Only 12 (27%) showed partial improvement re-irradiation over one-half (55%) failed respond deteriorated during soon retreatment. Brain necropsies performed in patients. Three these had developed necrosis most likely direct consequence. It is concluded that retreatment seldom worthwhile. usually short importantly, frequently not improved.