Therapeutical Attitude and Analysis of Results in Brain Metastases

Objectives - The aim of this study is to assess therapeutic outcomes in patients presenting with brain metastases as the first manifestation of malignancies either as a final stage in the evolution of malignancies. Materials and methods - We’ve performed a complex retrospective study on a total of 81 patients with brain metastases treated in Medical Oncology Clinic of the Emergency County Hospital Craiova between 1 January 2005-31 December 2010. Results - The average age of women (55 years) was statistically significantly low compared to men (64 years) (p = 0.000). The most affected age group was 51-60 years in women with maximum frequency of breast cancer and 61-70 years for men, with predominance of lung cancer. Most cases were presented with multiple metastases (90.12%) and the average latency-free interval from primary tumor detection to onset of symptoms was 29.8 months. Clinical manifestations, in most cases, occurred in less than 6 months after diagnosis of the primary tumor being a consequence of the evolution of disease at distance (36 patients / 62 patients in oncological evidence 58.06%) and 12 months after diagnosis survival rate was low being detected in patients with a controlled primary tumor and distant resumption of the disease (14 patients / 62 patients in oncological evidence-22.58%).Median survival in patients with irradiated brain metastases was 7 months. Multivariate statistical analysis of the survival rate has detected statistically significant differences depending on the type of the primary tumor (p = 0.000) and the manner of the onset of brain metastases as the first manifestation or evolution of neoplastic disease (p = 0.000).Survival was affected, without statistical significance threshold, by the number of metastases, patient gender and the loco-regional status of the primary tumor.