Improvement in Quality of Survival Following Whole-Brain Irradiation for Brain Metastasis

The benefits of palliative therapy for patients with brain metastases have often been questioned (1–4) since these patients usually have widely disseminated disease and a limited survival. Assessment of therapeutic gain or successful palliation has proved to be the most difficult task. Prolongation of life (2, 5), or “increased survival for at least six months without further disability” (3), has been the surgical criterion for success, and amelioration of signs was reported as the criterion in the largest radiotherapeutic series (6). Yet, ultimately, it is the improvement of the functional capacity of the patient, his regained intellectual awareness and physical abilities, that determines whether a palliative result has been achieved. It is the purpose of this study to review the clinical findings, results, and implications of the treatment of brain metastases in 108 patients treated with whole-brain radiation. A patient classification based on functional status, which defines improvement and reports suc...