Time for Reappraisal of Extracranial Treatment Options? Synchronous Brain Metastases From Nonsmall Cell Lung Cancer
| Autor: | Egbert F. Smit, Suresh Senan, Pieter E. Postmus, Joline S.W. Lind, Ben J. Slotman, Frank J. Lagerwaard |
|---|---|
| Přispěvatelé: | Pulmonary medicine, Radiation Oncology, CCA - Innovative therapy |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Radiosurgery Carcinoma Non-Small-Cell Lung Carcinoma Humans Medicine Stage (cooking) Lung cancer Aged Aged 80 and over Chemotherapy Performance status Brain Neoplasms business.industry Cancer Middle Aged medicine.disease Primary tumor Surgery Radiation therapy Oncology Female Cranial Irradiation business Whole-Body Irradiation |
| Zdroj: | Lind, J S W, Lagerwaard, F J, Smit, E F, Postmus, P E, Slotman, B J & Senan, S 2011, ' Time for Reappraisal of Extracranial Treatment Options? Synchronous Brain Metastases From Nonsmall Cell Lung Cancer ', Cancer, vol. 117, no. 3, pp. 597-605 . https://doi.org/10.1002/cncr.25416 Cancer, 117(3), 597-605. John Wiley and Sons Inc. |
| ISSN: | 0008-543X |
| Popis: | BACKGROUND. The optimal treatment of the primary tumor in patients with brain metastases (BM) from newly diagnosed nonsmall cell lung cancer (NSCLC) remains unclear. The authors aimed to identify patient groups with synchronous BM for whom radical treatment of the primary site may be appropriate. METHODS. The medical records of 167 patients treated at our center between November 2000 and June 2009 for newly diagnosed NSCLC and synchronous BM were reviewed. All patients underwent surgery/radiosurgery (n = 86) or whole-brain radiotherapy (WBRT; n = 81) for BM. Univariate and multivariate analyses assessed prognostic factors significant for overall survival (OS). RESULTS. Median OS of patients undergoing surgery/radiosurgery for BM was 12.1 months. Those undergoing “radical” thoracic treatment (n = 24) had a longer median OS (28.4 months) than those undergoing chemotherapy (n = 74; 12.1 months) or supportive therapy (n = 69; 5.6 months, P < .01). Patients with stage I thoracic disease (n = 23) had a longer median OS (18.5 months) than those with stage III (n = 43; 9.4 months) or with intra/extra-thoracic metastases other than BM (stage IV; n = 20; 2.7 months, P < .01). Median OS of WBRT patients was 3.7 months. One patient underwent radical thoracic treatment. Patients undergoing chemotherapy (n = 42) had a longer median OS (5.7 months) than patients undergoing supportive therapy only (n = 38; 1.6 months, P < .01). Performance status and age were also associated with OS. CONCLUSIONS. Radical thoracic treatments may be justified in selected patients |
| Databáze: | OpenAIRE |
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