title: Role of palliative radiotherapy in brain metastases.
abstract: BACKGROUND
  Brain metastases are a common manifestation of systemic cancer and exceed primary brain tumors in number and are a significant cause of neurologic problems. They affect 20-40% of all cancer patients. Aggressive management of brain metastases is effective in both symptom palliation and prolonging the life. Radiotherapy has a major role to play in the management of brain metastases.
  
  
  OBJECTIVE
  The aim of the study was to know the outcome of palliative radiotherapy in symptomatic brain metastases in terms of improvement in their performance status.
  
  
  METHODS
  This is a retrospective study of 63 patients diagnosed to have brain metastases and treated with palliative whole brain radiotherapy to a dose of 30 Gy in 10 fractions over two weeks between June 1998 and June 2007. Diagnosis was done in most of the cases with computed tomography scan and in a few with magnetic resonance imaging. Improvement in presenting symptoms has been assessed in terms of improvement in their performance status by using the ECOG scale.
  
  
  RESULTS
  Fifty-four patients completed the planned treatment. Eight patients received concurrent Temozolamide; 88% of patients had symptom relief at one month follow-up; 39/54 patients had a follow-up of just one to three months. Hence survival could not be assessed in this study.
  
  
  CONCLUSIONS
  External beam radiotherapy in the dose of 30 Gy over two weeks achieved good palliation in terms improvement in their performance status in 88% of patients. Addition of concurrent and adjuvant Timozolamide may improve the results.
authors.affiliation: Department of Radiotherapy, M. S. Ramaiah Medical College, Bangalore - 560 054, India.
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Bilimagga
authors.forename: S
authors.initials: S
authors.lastname: Nirmala
authors.forename: Karthik S
authors.initials: KS
authors.lastname: Rishi
authors.forename: Mg
authors.initials: M
authors.lastname: Janaki
authors.forename: Arul
authors.initials: A
authors.lastname: Ponni
authors.forename: Ag
authors.initials: A
authors.lastname: Rajeev
authors.forename: Suman
authors.initials: S
authors.lastname: Kalyan