Treatment of brain metastases from primary XXXX .

@entity1 @entity117 @entity2 @entity134 @entity230 @entity356
PURPOSE: A retrospective study of @entity1 treated at the Peter MacCallum Cancer Institute for brain metastases from primary @entity2 is presented. METHODS AND MATERIALS: The medical records of 416 @entity1 with the diagnosis of primary @entity2 who presented with, or subsequently developed, brain metastases during the period January 1984 to December 1987 were reviewed. Information on a number of factors of potential prognostic significance (sex, age, histology, performance status and interval between diagnosis of the primary and brain metastases) was collected. Details of surgery, radiation and @entity134 usage were recorded, and any @entity134 side effects documented. Survival was calculated from the date of diagnosis of brain metastases. Stepwise regression based on Cox's proportional hazards model was used to determine significant prognostic factors affecting survival. @entity1 with and without @entity134 side effects were compared using Yates's corrected chi-square test. RESULTS: The overall estimated median survival was only 3.3 months (95% confidence interval 2.9-3.7 months). Only two factors were found to be associated with a significantly improved survival--surgical intervention and good performance status. After taking these two factors into account, the dose of radiation used (< 30 Gy or > or = 30 Gy) did not influence survival. There was a 3% incidence of @entity356 or perforation in @entity1 taking @entity230 , with a 40% fatality rate. Predisposing factors to gastric side effects were a prior history of peptic ulcer and/or @entity117 or nonsteroidal anti-inflammatory drug consumption. CONCLUSION: Radiation of brain metastases from primary @entity2 results in modest survival benefit. Radiation dose (< 30 Gy or > or = 30 Gy) is not a significant determinant of survival. Other treatment modifications, such as concurrent radiation and chemotherapy, should be explored. Steroids should be used with caution as fatal side effects can occur.
