%0 Journal Article
%T Patterns of Treatment and Outcome in Patients With 20 or More Brain Metastases.
%A Nieder C
%A Yobuta R
%A Mannsåker B
%J In Vivo
%V 33
%N 1
%D Jan-Feb 2019
%M 30587619
%F 2.406
%R 10.21873/invivo.11455
%X <B>OBJECTIVE: </B>The aim of this study was to analyze the patterns of treatment and outcomes in patients with a large number of brain metastases, arbitrarily defined as 20 or more lesions. These patients are typically excluded from studies of focal brain treatment, e.g., surgery or radiosurgery, and might have a limited prognosis.<BR><B>METHODS: </B>This was a retrospective single-institution analysis. Overall, 11 patients were identified from a prospectively maintained database.<BR><B>RESULTS: </B>Ten patients had received active treatment (9 whole-brain radiotherapy, 7 systemic therapy). Median survival was 5.0 months without long-term survival beyond 13 months. Patients with better performance status had numerically longer survival, however we did not identify baseline parameters with a significant impact on survival.<BR><B>CONCLUSIONS: </B>While long-term survival was not observed in this small study, most patients survived long enough to experience symptomatic improvement from whole-brain radiotherapy. Therefore, we recommend multidisciplinary assessment of the patients' prognosis and systemic treatment options, and initiation of whole-brain radiotherapy if survival is not limited to 1-2 months.