November 4, 1998

Treatment of a Single Brain MetastasisThe Role of Radiation Following Surgical Resection

Author Affiliations

From the Department of Surgery, Division of Neurosurgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario (Dr Mintz), and the Departments of Clinical Neurological Sciences and Oncology, University of Western Ontario, London, Ontario (Dr Cairncross).

JAMA. 1998;280(17):1527-1529. doi:10.1001/jama.280.17.1527

Metastatic brain tumors are the most common intracranial neoplasms.1 Fifteen percent to 30% of patients with cancer develop cerebral metastases during the course of their illness.2,3 Carcinomas of the lung, breast, colon, and kidney and malignant melanoma are the common primary sources. At the time of neurologic diagnosis, 50% of patients will have a single brain metastasis shown on computed tomographic scan,4,5 whereas fewer than 30% will have only 1 lesion shown on magnetic resonance imaging, a more sensitive imaging method.6 The median survival of untreated patients with brain metastases is approximately 1 month,7 although survival time can be doubled by the use of corticosteroids.8 When added to corticosteroid treatment, whole-brain radiation therapy may further improve neurologic function with tolerable morbidity, although survival times remain short, ranging from 3 to 6 months.9,10

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