Rapid-course radiation therapy of cerebral metastases: Results and complications

Abstract

Eighty-three patients (Group A) with parenchymal brain metastases were treated with “rapid-course” whole brain irradiation (1500 rad in 2 treatments) and the results were compared retrospectively with a group of 79 patients (Group B) treated conventionally (approximately 3000 rad in 15 treatments). Neurologic improvement occurred in 57% of patients in Group A and 62.3% of Group B. Median duration of remission was shorter in Group A: 2.0 vs. 3.5 months (p = 0.059); median duration of survival was significantly shorter in Group A: 59 vs. 116 days (p < 0.02) (means: 103 vs. 147 days). Complications were significantly more frequent in Group A: 49.4% vs. 15.2% (p < 0.01). These included acute cerbral herniation (6 cases in Group A, 3 cases in Group B), headache, nausea and vomiting, and fever. The major advantage of the rapid course is the reduction of the period of treatment. Since lethal complications occurred primarily in patients with evidence for markedly elevated intracranial pressure, the “rapid course” should probably be withheld in such patients.