[Treatment of metastatic brain tumors: effect of surgery of multiple metastatic brain tumors and systemic metastasis with special reference to quality of life].

To assess the efficacy of surgical resection of brain metastases from patients with multiple brain metastases or/and with other systemic metastases, the authors analysed treatment results of 90 cases of metastatic brain tumors. The patients were divided into three groups. Group A (nine cases): Patients with single brain tumor and their primary cancers were well controlled. Their brain tumors were removed surgically and followed by radiation. Their mean survival time was 17.0 months, and 14.6 months were independent (Karnofsky score greater than or equal to 70) in cases of lung cancer. Five patients (55.6%) improved by treatment. Group B (21 cases): Patients with multiple brain metastases or/and with systemic metastases. Their brain tumor(s) which gave rise to neurological symptoms were surgically removed in order to improve their quality of life. In cases of lung cancer, mean survival time was 9.5 months and 7.1 months were independent. 11 patients (52.3%) improved by treatment. Group C (60 cases): Patients treated conservatively. Their mean survival time was 4.9 months and 2.7 months were independent in cases of lung cancer. Only 13 patients (21.7%) improved by treatment. However 23 (38.3%) deteriorated in their quality of life during treatment. Two patients of this group had single brain tumor and their primary cancers were controlled well. They refused surgery. Their mean survival time was 13.0 months, and 7.0 months were independent. These times were statistically shorter than group A. Seven patients had similar systemic and neurological states as those in group B. Their mean survival time was 5.0 months and 3.0 months were independent. These times were also statistically shorter than those in group B.(ABSTRACT TRUNCATED AT 250 WORDS)