Brain Metastases from Solid Tumors: an Institutional Study from South India

Background: Brain metastases are the most common intra-cranial neoplasms. The incidence is on a rise dueto advanced imaging techniques. Aims: The objective of the study was to analyse the clinical and demographicprofile of patients with brain metastases from primary solid tumors. Materials and
Methods: This is a retrospectivesingle institutional study covering 130 consecutive patients with brain metastases from January 2007 to August2014.
Results: Some 64.6% of the patients were females. The majority were in the sixth decade of life. The siteof the primary tumor was the lungs in 50.8% of the cases. The overall median time from the diagnosis of theprimary malignancy to detection of brain metastases was 21.4 months. Survival was found to be significantlyimproved in patients with solitary brain lesions when compared to patients with multiple brain metastases,and in patients undergoing surgical excision with or without cranial irradiation when compared to wholebrain irradiation alone. The majority of the cases belonged to the recursive partitioning analysis class II group.Whole brain radiation therapy was delivered to 79% of the patients.
Conclusions: Most of the patients withbrain metastases in the study belonged to recursive partitioning analysis classes II or III, and hence had poorprognosis. Most of the patients in the Indian context either do not satisfy the indications for surgical excision orare incapable of bearing the high cost associated with stereotactic radiosurgery. Treatment should be tailoredon an individual basis to all these patients.