Radiation therapy for metastatic brain tumors from bronchogenic carcinoma

Sixty-two patients with brain metastases from bronchogenic carcinoma, treated by irradiation between April 1979 and March 1986, were reviewed. All patients received whole brain irradiation using lateral parallel opposed portals. Treatment was started with small daily doses of 0.5 to 0.7 Gy that were gradually increased to 1.8 to 2.0 Gy per day. In most cases, the planned dose ranged from 40 Gy to 50 Gy. The overal median survival in this series was 3.3 months with a 1-year survival rate of 8.9 %. Significant neurologic improvement was obtained in 61 % of the patients. Statistical analyses of the data revealed that patients without uncontrolled metastases to other organs had a significantly longer survival than those with such metastases. Patients with mild or no neurologic deficits (neurologic function classes of RTOG 1 and 2) at the start of the irradiation to the brain showed the longest survival, and patients with normal serum lactate dehydrogenase (LDH) value also had a longer survival than those with abnormally high serum LDH value. Fifteen patients failed to complete the protocol treatment, the main reason being deterioration or death. Few of them showed improvement in neurologic deficits. A significant relationship was observed between the incompletely irradiated group and the subgroups of patients with following factors: uncontrolled metastases to other organs, the high LDH value, leukocytosis or anemia. (author)