Prognostic evaluation before operative extirpation and radiotherapy of solitary brain metastasis

Pellettieri, Luigi; Sjölander, U.; Jakobsson, K. E.

doi:10.1007/bf01419497

Cited by 14 publications

(1 citation statement)

References 6 publications

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“…Both our group 18,32,65,66 and others 48,87 have found that performance status and neurological status are two of the most important pretreatment variables to affect median survival, both in patients treated with WBRT alone 13 and in patients undergoing craniotomy. Present findings confirm these earlier reports.…”

Section: Performance Statusmentioning

confidence: 70%

Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991

Wroński

Arbit²,

Burt³

et al. 1995

Journal of Neurosurgery

203

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The authors reviewed the records of 231 patients who underwent resection of brain metastases from nonsmall-cell lung cancer between 1976 and 1991. Data regarding the primary disease and the characteristics of brain metastasis were retrospectively collected. Median survival in the group from the time of first craniotomy was 11 months; post-operative mortality was 3%. Survival rates of 1, 2, 3, and 5 years were 46.3%, 24.2%, 14.7%, and 12.5%, respectively. One hundred twelve women survived significantly longer than 119 men (13.8 vs. 9.5 months, p < 0.02). Patients with single metastatic lesions (200 patients) survived longer than those (31 patients) with multiple metastases (11.1 vs. 8.5 months, p < 0.02). Patients with supratentorial tumors survived longer than patients with cerebellar lesions. A high Karnofsky performance scale score before surgery also indicated increased survival. In multivariate analyses, incomplete resection or no resection of primary lung tumor, male gender, infratentorial location, presence of systemic metastases, and age older than 60 years were significantly correlated with shorter survival. Approximately one-third of the patients died of neurological causes, one-third of systemic disease, and one-third of a combination of both. The results of this series confirm that the overall prognosis for patients with even a single resectable brain metastasis is poor, but that aggressive therapy can prolong life with quality of life preserved and can occasionally permit long-term survival.

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Section: Performance Statusmentioning

confidence: 70%

Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991

Wroński

Arbit²,

Burt³

et al. 1995

Journal of Neurosurgery

203

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Value of surgery and radiotherapy in the treatment of brain metastases

Nieder

Niewald

Schnabel

et al. 1994

Radation Oncology Invest

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SUMMARY In this study the results of surgery and radiotherapy (RT) in 26 patients, compared with those of 42 patients who had only RT are analyzed. The most frequent sites of primary tumors were the lung and breast. In the first years 20 x 2 Gy was given; later on 10 x 3 Gy was administered. Sixteen non-operated patients received 20 x 2 Gy followed by a local boost of 10-20 Gy. Because a matched cohort pair method was chosen for this analysis, all prognostic factors were equally distributed between the operation (OP) + whole-brain irradiation (WBI) and the WBI only group. The local remission rate after OP + WBI was 81% vs. 38.5% after WBI only and 69% after WBI + boost. Median survival after surgery (17 months) was significantly longer, but the dose of R T had no influence on survival (7 vs. 8 months). The distribution of prognostic factors was significantly different between the WBI + boost group and the other groups, and therefore a prospective randomized trial will become necessary to verify the superiority of surgical treatment compared to "high-dose" RT. When compared to "standard" R T equivalent to the 10 x 3 Gy schedule, surgery + RT is significantly superior.

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Metastases to the Central Nervous System

2002

TxNxM1

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Prognostic evaluation before operative extirpation and radiotherapy of solitary brain metastasis

Cited by 14 publications

References 6 publications

Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991

Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991

Value of surgery and radiotherapy in the treatment of brain metastases

Metastases to the Central Nervous System

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