IRRADIATION OF BRAIN METASTASES FROM LUNG-CANCER - A RETROSPECTIVE STUDY

A total of 94 patients with brain metastases from lung carcinomas were treated with irradiation of their brain metastases. Two fractionation schedules were applied, a non-conventional one (76 patients) mixing h ypofractionation and accelerated hyperfractionation to a total dose of 47 Gy and a conventional one (18 patients), with 3 Gy once a day to a total dose of 30 or 36 Gy. No benefit was found for the non-conventio nal treatment schedule over the conventional one. A difference in surv ival was demonstrated between patients whose brain metastases originat ed from adenocarcinoma or squamous cell carcinoma of the lung with a m edian survival of 3.5 and 1.9 months, respectively (P = 0.006). Median survival of patients with brain metastases from small cell lung cance r (SCLC) was 2.8 months, and when compared with the squamous cell carc inoma group, there was no statistically improved survival (P = 0.12). There were indications of a better palliative effect in adenocarcinoma s compared with squamous or large cell carcinomas. In a few patients ( 1/22 adenocarcinoma and 7/32 SCLC), the patients were free from malign ant cells in the brain at autopsy, demonstrating that irradiation of b rain metastases might be efficient in certain patients. (C) 1998 Publi shed by Elsevier Science Ireland Ltd. All rights reserved.