Mustafa ÜNSAL, Süleyman ALTIN, M. Yakup BÜYÜKPOLAT, M. Ferhan ADATEPE, Mustafa İZMİRLİ

Beyin metastazıyla başvuran primeri bilinmeyen kanserli hastalarda palyatif entansif hipofraksiyone tüm beyin radyoterapisi sonuçları

AMAÇ Bu çalışmada beyin metastazı ile tanı konulmuş ve primeri bilinmeyen 24 hastaya uygulanan palyatif amaçlı hipofraksiyone radyoterapi sonuçları retrospektif olarak incelendi.GEREÇ VE YÖNTEM Yirmi dört hastaya (20 erkek (%83.4), 4 kadın (%16.6); ort. yaş 61; dağılım 24-75 yıl) radyoterapi, 10 Gy fraksiyon dozlarında, 10 gün arayla; 3 fraksiyonda 30 Gy tümör dozu verilecek şekilde uygulandı. Tüm hastalara antiödem tedavi verildi. Bir hastada Karnofsky Performans Statüsü 70, diğer hastalarda 70'in altında idi. Hastaların %79.2'sinde multipl metastaz vardı; %20.8'inde tek lezyon mevcuttu ve yalnızca bu hastaların histopatolojik tanısı vardı. Hastaların %50'sinde hemipleji, %45.8'inde hemiparezi ve %4.2'sinde quadripleji ile 6 hastada (%25) bunlara ek patolojiler vardı. Tedaviye 13 hastada başvuruda bulundukları gün başlandı.BULGULAR Radyoterapi sonrası değerlendirmede hastaların %8.3'ünde nörolojik semptomlarda tam düzelme, %37.5'inde parsiyel düzelme, toplamda %45.8'inde nörolojik semptomlarda iyileşme görüldü. Sağkalım oranları ort. 2.87 ay olup altı aylık sağkalım %33.3, bir ve iki yıllık sağkalım %8.33 idi. Sonuçlarımız kötü performanslı hastalarda uygulanan diğer radyoterapi şemalarıyla benzer oldu (KPS

The results of palliative intensive hypofractionated radiotherapy from patients having brain metastases with unknown primary tumour

OBJECTIVES We retrospectively examined the results of hypofractionated radiotherapy from 24 patients having brain metastases with unknown primary.METHODS Radiotherapy was administered to 24 patients (20 males (83.4%), 4 females (16.6%), age range 24-75 years) as 10 Gy fraction doses with 10 days intervals for a total of 30 Gy tumour dose in 3 fractions. Antiedema treatment was given to all patients. Karnofsky performance status was 70 for one patient and below 70 for the rest of the patients. Multiple metastases were present in 79.2% of the patients, in 20.8% of the patients there was single lesion and histophatologic diagnosis was present only for this group. 50% of the patients had hemiplegia, 45.8% had hemiparesia, 4.2 % had quadriplegia and 6 patients (25%) had other additional pathologies. Treatment was started at the day of admission for 13 patients.RESULTS The total and partial reliefs in neurological symptoms were seen in 8.3% and 37.5% of patients, respectively. Median survival from diagnosis of brain lesions was 2.87 months. The six months, 1 and 2 years survival rates were 33.3%, 8.33%, and 8.33%, respectivel y. The prognosis of patients with brain metastases is poor and have similar survival rates from the other poor performance patients (KPS

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