THE EFFICACY OF CRANIAL IRRADIATION IN OVARIAN-CANCER METASTATIC TO THE BRAIN - ANALYSIS OF 32 CASES

Objective: To determine the role of irradiation in the management of b rain metastases from epithelial ovarian cancer. Methods: Tumor registr ies from five university cancer centers were searched to identify ovar ian cancer patients with brain metastases. During a 30-year period (19 65-1994), 4027 ovarian cancer patients were evaluated, 32 of whom were found to have cerebral metastases. Each received fractionated whole-b rain irradiation (median dose 30 Gy, range 20-52.5). Five patients rec eived concomitant chemotherapy with whole-brain irradiation. Results: The median survival time for the whole population was 4 months. For th e entire series, symptomatic response (complete response and partial r esponse) was achieved in 23, 16 of whom were palliated until death. Pa tients with higher Karnofsky performance status (70 or above versus be low 70) were more likely to derive a palliative response and attained a statistically significant survival advantage. No other fact-or predi cted the likelihood of deriving a palliative response or a survival ad vantage after treatment. Conclusions: In this large review of patients with cerebral metastases from ovarian cancer, we found that most of t hose treated with whole-brain irradiation achieved palliation until de ath. Nearly all women with high performance status derived durable pal liation from cerebral irradiation. Whole-brain irradiation was an effe ctive means of palliating ovarian cancer metastatic to the brain and p rovided a favorable alternative to other means of management.