Flentje M, Kober B, Kohlmann H, Schneider G, Kimmig B
Strahlenther Onkol. 1987 Mar;163(3):148-53.
Between 1979 and 1985, 193 patients were submitted to radiotherapy of the brain for formation of metastases. A primary irradiation was performed in 159 patients, 34 patients had been treated by surgery. The median survival time after diagnosis of all irradiated patients (40 to 60 Gy within four to six weeks) was 4.9 months, 22% of the patients survived one year. Patients with mammary carcinomas and patients with bronchial carcinomas showed marked differences in median survival times (4.2 and 6.9 months, respectively) and one-year survival rate (11% and 32%, respectively). In histologic examination, the extent of extracerebral formation of metastases was the decisive parameter for survival. At the end of radiotherapy, 47% of patients showed an amelioration in neurologic deficiency, 16% deteriorated. A follow-up by computed tomography with observation periods between four and 34 months was possible in 84 patients. Most of these patients showed improvement in computed tomography during a period of four to twenty weeks after the beginning of radiotherapy. Later on, about two thirds of the controlled patients had again deterioration with local progression or new formation of metastases in spite of total brain irradiation. A long-term normalization (greater than one year) was observed only in patients with mammary carcinomas.
1979年至1985年间，193例患者因发生脑转移而接受脑部放疗。159例患者接受了初次放疗，34例患者曾接受过手术治疗。所有接受放疗患者（4至6周内给予40至60 Gy剂量）诊断后的中位生存时间为4.9个月，22%的患者存活了1年。乳腺癌患者和支气管癌患者在中位生存时间（分别为4.2个月和6.9个月）和1年生存率（分别为11%和32%）方面存在显著差异。组织学检查显示，脑外转移灶的范围是生存的决定性参数。放疗结束时，47%的患者神经功能缺损有所改善，16%的患者病情恶化。84例患者可行计算机断层扫描随访，观察期为4至34个月。这些患者中的大多数在放疗开始后的4至20周内计算机断层扫描显示有所改善。后来，尽管进行了全脑照射，约三分之二病情得到控制的患者仍出现病情恶化，表现为局部进展或出现新的转移灶。仅在乳腺癌患者中观察到长期病情缓解（超过1年）。
