Intracranial metastases in small cell carcinoma of the lung prognostic aspects

Autor: Heine H. Hansen, Olaf B. Paulson, S. Olesen Larsen, Fred R. Hirsch
Rok vydání: 1983
Předmět:
Zdroj: Cancer. 51:529-533
ISSN: 1097-0142
0008-543X
Popis: Two hundred-twelve consecutive patients with small cell carcinoma of the lung were studied in order to correlate the risk of developing intracranial metastases to the initial stage of the disease (locoregional versus extensive) and to evaluate the prognostic significance of developing intracranial dissemination of the disease. Clinically detected intracranial metastases were observed in four percent at the time of primary diagnosis, and an additional 18 percent developed metastases during treatment. As regards clinically observed metastases during treatment, no difference was found between the two initial staging groups. Intracranial metastases without clinical evidence of progressive disease elsewhere were demonstrated in 10 out of 205 patients (5%). The median survival time after clinical presentation of intracranial metastases was 85 days for patients with locoregional disease versus 60 day$ for patients with extensive disease. A significantly shorter survival time was observed for patients with intracranial metastases at 0, 100,200 and 300 days after start of treatment compared to patients still alive without metastases at those times. Brain autopsy was performed in 82 patients and was positive in 42 (51%). No statistical difference in the frequency of brain metastases was demonstrated when compared to the initial stage of the disease. No difference was observed between the two initial staging groups of patients with regard to risk of developing brain metastases. Autopsy substantiated that there was no difference between patients with and without brain metastases as regards survival. However, clinical intracranial metastases were followed by a short survival time, and only a small fraction of the patients developed clinically isolated intracranial relapse. Cancer 51529-533, 1983. VER THE PAST DECADE, intracranial metastases in 0 patients with small cell carcinoma of the lung (SCCL) have become an increasingly important clinical problem. This problem was already in focus in 1973 when Hansen reported that 42% of the patients with SCCL developed brain metastases during chemotherapy, with a risk of 66% in patients surviving more than one year after initiation of treatment.' This finding was supported later by other inve~tigators.'-~ The prognosis after presentation of intracranial metastases has been reported as being poor, with a median survival time of 2-3 months after initiation of cranial irradiati~n.~-~ However, some authors have reported individual long-term survivors (> 17 months) among patients irradiated for brain metastases if systemic disease was under ~ontrol.~.~
Databáze: OpenAIRE
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