Brain metastasis from melanoma

Eighty-one patients with brain metastasis from melanoma were identified at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1978 and 1980. Of 78 evaluable patients, 51 (65%) had multiple brain metastases. Of 64 patients with non-contrast CT scans, 29% had hemorrhagic metastases. Leptomeningeal...

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Bibliographic Details
Published in:Journal of neuro-oncology 1983, Vol.1 (4), p.313-317
Main Authors: Byrne, T N, Cascino, T L, Posner, J B
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Anticonvulsants - therapeutic use
Brain Neoplasms - secondary
Brain Neoplasms - therapy
Combined Modality Therapy
Female
Humans
Male
Melanoma - secondary
Melanoma - therapy
Meningeal Neoplasms - secondary
Meningeal Neoplasms - therapy
Middle Aged
Radiotherapy Dosage
Seizures - prevention & control
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Summary:Eighty-one patients with brain metastasis from melanoma were identified at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1978 and 1980. Of 78 evaluable patients, 51 (65%) had multiple brain metastases. Of 64 patients with non-contrast CT scans, 29% had hemorrhagic metastases. Leptomeningeal metastases were found in 15 patients. Patients were grouped into three categories: Group 1, multiple brain metastases treated with radiation therapy (RT) (n = 49); Group 2, single brain metastasis treated with RT (n = 17); Group 3, single brain metastasis treated with surgery with or without RT (n = 9). Median survivals for Groups 1, 2 and 3 were 11, 9 and 41 weeks, respectively. Eighty-six percent, 65% and 33% of patients in Groups 1, 2 and 3, respectively, were steroid-dependent until death. Seizures occurred in 38 patients (48%). In 17 (21%), seizures were the first manifestation of metastasis. Of 51 patients not receiving prophylactic anticonvulsants, 37% had seizures. Of 12 patients treated prophylactically, 17% developed seizures. Surgical extirpation should be considered in highly selected patients with brain metastasis from melanoma. Prophylactic anticonvulsants are recommended if there is no contraindication.
ISSN:0167-594X
1573-7373
DOI:10.1007/BF00165714