Clinical Gastroenterology Vol.21 No.3(2-7)

Theme Radiotherapy for Cancers of Digestive Organs
Title Radiotherapy for Brain Metastases
Publish Date 2006/03
Author Ta-Chen Chang Department of Radiology, Tokyo Metropolitan Komagome Hospital
Author Katsuyuki Karasawa Department of Radiology, Tokyo Metropolitan Komagome Hospital
Author Mutsumi Kawakami Department of Radiology, Tokyo Metropolitan Komagome Hospital
Author Nahoko Hanyu Department of Radiology, Tokyo Metropolitan Komagome Hospital
Author Masahiko Okamoto Department of Radiology, Tokyo Metropolitan Komagome Hospital
Author Yurie Kikuchi Department of Radiology, Tokyo Metropolitan Komagome Hospital
[ Summary ] Brain metastases occur in 20 - 40 % of patients with cancer ; the percentage of metastases from colon and gastrointestinal tumors is approximately 5 - 10 %. The treatment of brain metastases generally employs whole brain radiotherapy (WBRT), postoperative WBRT and stereotactic radiosurgery (SRS) determined by evaluation of location, size, and number of brain metastases. The most commonly employed treatment schedule for WBRT consists of a total dosage of 30 to 40 Gy in 2.5 to 3-Gy in daily fractions. Metastases are usually <2 cm in diameter if the total number of metastases is, from one to four, rendering them ideal targets for SRS. A single fraction of 25 - 30 Gy SRS was generally prescribed. Following WBRT, more than 50 % of patients showed improvement in neurologic condition. For <2 cm of metastases treated with SRS, the local tumor control rate at 1 year was >70 %. From the viewpoint of patient's quality of life and medication cost / benefit ratio, radiation for brain metastases should be widely employed.
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