Brain metastases in patients with no known primary tumor.

摘要: BACKGROUND The care of patients with a brain metastasis from unknown primary site is controversial. The authors reviewed the results stereotactic radiosurgery in this group to better define clinical expectations. METHODS During an 11-year interval, was performed 421 metastases at University Pittsburgh. Fifteen had solitary or multiple (≤ 5) without detectable time initial presentation. In five patients, histologic diagnosis cancer obtained extracranial metastatic sites. 10 brain. A total 31 tumors mean volume 4.3 mL (range, 0.05–18.6 mL) underwent marginal dose 16.2 Gray (Gy) 12–20 Gy). Fourteen (93.3%) also received whole fractionated radiation therapy. RESULTS The median survival 15 months after 1–48 months) and 27 their cancer. 4 (26.7%), tumor discovered later (lung 3 liver 1). Three these four died due progression tumor. Of remaining 11 metastases, 2 other systemic diseases, because metastasis. (20%) were still living between 21–48 radiosurgery. presence active disease stem location both associated poor outcome (P = 0.004 0.04). actuarial imaging-defined local control rate 91.3 ± 5.9% years. CONCLUSIONS Radiosurgery effective strategy for site. Disease outside usual cause patient death. Cancer 2000;89:1095–1101. © 2000 American Society.