Stereotactic radiosurgery supplementing total brain irradiation in the treatment of brain metastases

Objective To analyse the impact of combined regimen of total brain irradiation (TBR) and X ray stereotactic were 10 months, 14.5% (8/55) and 13 months in the SRS plus TBR group, as compared with 4 months ,41.2% (7/17) and 7.5 months in the S radiosurgery (X knife,SRS) on brain metastases. Methods From October, 1997 to December, 1999, 55 patients with brain metastases were treated by SRS plus TBR and 17 patients by SRS alone. The dose of TBR was 30～42Gy/4～5 weeks, 1.5～2.0 Gy per fraction and that of SRS 18～30Gy. Results The overall response rates (CR+PR) were 92.7% in the TBR plus SRS group , and 76.2% in the SRS alone group with significant difference (P0.05). The median recurrent period , recurrent rate and median survival period were 10 months,14.5%(8/55) and 13 months in the TBR plus SRS group, as compared with 4 month's,41.2%(7/17) and 7.5 months in the RS alone group (P0.05). The differences approached only near to statistical significance. The 1 year survival and mortality rates were 63.6%, 36.4% and 41.7%,52.9% in the above groups (P0.05). Conclusions For brain metastases, irradiation of the entire intracranial contents combined with stereotactic radiosurgey (X knife) has a significant impact on improving the local contol and ultimate outcome.