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[Palliative radiotherapy of brain metastases of solid tumors: experiences with high doses].

Results of palliative high dose irradiation in 145 patients with brain metastasis of various carcinomas are reported. All patients had whole brain irradiation by parallel opposed lateral fields with a midline dose of 13 to 14 x 300 cGy in 2,5 to three weeks. Patients with solitary brain metastasis received a local boost with 5 x 200 cGy. Twelve patients had also surgical excision of the brain metastasis. 39% of the patients had a marked improvement (good or very good neurological function class) and 30% had a moderate improvement. Neurologic function was stabilized in an improved state for 93% of the remaining survival time. This result corresponds to the observations of the RTOG in a randomized study of various doses, resulting in a standard dose of 10 x 300 cGy, but there is a small subgroup with a relatively favourable prognosis benefitting from surgery and irradiation or irradiation alone with a higher dose and conventional fractionation.