An evaluation of the management of patients with cerebral metastases from malignant melanoma

Abstract

In an attempt to evaluate the response to whole-brain irradiation with chemotherapy and/or corticosteroids, the results of 41 patients with cerebral metastases from malignant melanoma were analyzed. Patients received a median tumor dose of 3000 rads delivered to the entire brain over a 2-week period. Twenty-four patients received concomitant chemotherapy and corticosteriods, and 14 others received either chemotherapy or corticosteroids. The median and mean survival from completion of irradiation for all patients were 86.5 and 103+ days, respectively (range: 4 to 436+ days). Sixteen patients (39%) showed definite neurologic improvement and had a median survival of 131 days. The median survival of the 25 nonresponding patients was only 17 days (p < .002). The median duration of improvement was 60 days (range: 30–465 days). The most frequently seen responses included return of limb function, disappearance of confusion, somnolence and coma, and cessation of headaches, nausea, and vomiting. Patients with neurologic improvement tended to have more indolent disease than those who did not respond.