Brain metastasis: Clinical characteristics and prognosis.
- Author:
Jae Lyun LEE
1
;
Chang Jin SHIN
;
Hee Jeong KANG
;
Hyun Ah OH
;
Gu LEE
;
Jae Hyuk CHOI
;
Sung Hwa BAE
;
Kyung Hee LEE
;
Myung Soo HYUN
;
Sei One SHIN
;
Hyun Mo RYOO
Author Information
1. Division of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea.
- Publication Type:Original Article
- Keywords:
Brain neoplasms;
Neoplasm metastses;
Radiotherapy
- MeSH:
Brain Neoplasms;
Brain*;
Breast Neoplasms;
Drug Therapy;
Gastrointestinal Neoplasms;
Humans;
Kidney Neoplasms;
Lung Neoplasms;
Neoplasm Metastasis*;
Palliative Care;
Prognosis*;
Radiotherapy;
Retrospective Studies;
Survival Rate;
Treatment Outcome
- From:Korean Journal of Medicine
2002;62(4):444-452
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Brain metastasis is a common complication in cancer patients. We evaluated the clinical characteristics, treatment outcome and prognostic factors for patients with metastatic brain tumor. METHODS: The records of 97 patients with metastatic brain tumor during the period from January 1991 to November 1997 were reviewed retrospectively. RESULTS: The most common primary tumor is lung cancer (61 cases, 63%) followed by metastatic cancer unknown primary site (15 cases, 16%), gastrointestinal cancer (13 cases, 13%), breast cancer (6 cases, 6%) and renal cancer (2 cases, 2%). There were 44 patients with a single brain metastasis and 53 patients with multiple brain metastases. The median survival was 3.0 months and one-year survival rate was 8% irrespective of treatment. Favorable prognostic factors which affect survival were ambulatory status (p<0.01) and functional neurologic class 1, 2 (p<0.01). Median survival was 3.7 months for patients with steroid therapy and 1.1 months with no therapy (p<0.01). Median survival was 4.8 months for patients with steroid therapy plus whole brain radiotherapy (WBRT) and 2.2 months with steroid therapy alone (p<0.01). Additional chemotherapy did not appear to affect the survival. The patients treated with surgery had median survival time of 8.8 months compared with 2.5 months for patients treated with steroid therapy plus WBRT (p<0.05). CONCLUSION: In present study, we confirmed that whole brain irradiation and corticosteroid administration are effective palliative treatment for patients with metastatic brain tumor. Initial performance status and neurological function were identified as important prognostic factors. Although confounded by the limitations of retrospective study, more aggressive treatments including surgery and chemotherapy could be regarded to have a significant role to achieve better treatment outcome in some selected cases.
