HFSRT With Concurrent TMZ for Large BMs

Inclusion Criteria:

• histologic or cytological diagnosis of primary tumor and conformed brain metastases by enhanced MRI or CT;
• the number of BMs ≤ 3
• the tumor volume ≥6cc, or maximum diameter of BMs≥ 3cm;
• Karnofsky performance score (KPS)≥60, or KPS≥40 but simply caused by BMs;
• Age: 18-75 years old;
• Adequate function of major organs, and blood test reached the following level: WBC≥4.0x109/L, NEU≥1.5x109/L Hemoglobin≥110 g/L, Platelets≥100 x109/L; Liver function test results<1.5 times the institutional upper limit of normal (ULN); BUN and Cr: within the normal range.

Exclusion Criteria:

• patient with other clinically significant diseases (e.g. myocardial infarction within the past 6 months, severe arrhythmia);
• unable or unwilling to comply with the study protocol;
• patient whose survival expectancy was less than 3 months;
• the large BM locates in brainstem;
• patient who anticipated in other clinical trials of brain metastases;
• the large lesions have been treated with SRT in other hospitals;
• pregnant patients or female patients whose HCG is positive.