gms | German Medical Science

Objective: RS is a well-known and effective local therapy for patients with small brain metastases. In case of larger metastases located within functional brain regions, hfSRT can be a less risky treatment. RS and hfSRT were evaluated in view of survival times.

Method: 268 patients (95 women, 173 men, mean age: 57 y) have been evaluated. 173 patients were treated with RS (mean 19 Gy), while 95 patients received a hfSRT (6-7 x 5 Gy or 10-11 x 4 Gy). The survival times of both groups have been analyzed in respect to the prognostic factors.

Results: Within the hfSRT group, the mean tumor volume was with 6.8 ml higher than in the RS group with 4.1 ml. Neurological deficits were seen in significantly more hfSRT cases (74% vs. 49%, p=0.0001), but did not have significant influence on the survival time. The one year survival time for all patients was 23%, for RS patients (25%)it was slightly higher than for hfSRT (20% - p=0.63). The mean survival time for RS patients was 8.6 months vs. 8.1 months for hfSRT patients. In case of bronchial carcinomas (n=85) it was 9.2 vs. 8.1 months. In case of colorectal carcinomas (n=27) it was 9.7 vs. 5.7 months. In case of renal cell carcinomas, the mean survival time was 9.8 vs. 11 months. In the Kaplan-Meier analyses, no significant differences between RS and hfSRT were to be found in 13 of the 17 patients. There were also no significant differences between the two groups concerning age, Karnofsky score, local control of primary tumor, singular vs. multiple metastases, metastases size (< vs. > 2 cm) and RPA classification.

Conclusions: In respect to survival times, RS and hfSRT are similarly effective methods. HfSRT is an efficient, low-risk and palliative therapy option, particularly for patients with larger brain metastases and neurological deficits.