[Treatment results in brain metastases with primary irradiation and after surgery and postoperative irradiation].

61 patients with cerebral metastases were treated between 1977 and 1982, 32 out of them were operated and postoperatively irradiated, 29 only irradiated. The irradiations were given for curative purposes. Sixteen patients were alive at the date of December 31, 1982. The survival times calculated with the method of Kaplan-Mayer were 10 months after surgery and irradiation and 5 months after irradiations alone. In case of metastases of the mammary carcinoma, surgery with irradiation seems to be an especially effective method, as is suggested by the median survival time of 35 months and the total absence of local recurrences. In most of the other cases, too, the prolonged survival time was accompanied by a good quality of life which lasted for a considerable period of time. Younger patients had a longer survival time than older patients. The results of a high-dosed therapy with several daily fractions, namely 60 Gy within 17 days or 1825 ret NSD, respectively, were not (yet) better than those of conventional fractionation and dosage with 50 to 60 Gy in 5 to 6 weeks or 1572 to 1768 ret NSD, respectively. However, the value of this method was the same, its advantage lying in the shorter treatment time. Only in patients over 60 years, above all if they had received a total-brain irradiation with this method, we think to have seen a more frequent development of psychosyndromes. (The calculation of the survival times includes all cases, even patients who died during or shortly after radiotherapy).