BACKGROUND: The optimal treatment for non-small cell lung cancer (NSCLC) patients with asymptomatic brain metastasis is still controversial. This study aimed to analyze the outcome for various treatment modalities including chemotherapy only, upfront whole brain radiotherapy (WBRT) or stereotactic radiosurgery (SRS) in NSCLC patients with asymptomatic brain metastases. METHODS: We retrospectively reviewed the medical records of patients with histopathologically proven NSCLC and synchronous asymptomatic brain metastasis between January 2003 and December 2007. RESULTS: From the database, 741 NSCLC patients were identified to have been diagnosed of brain metastases during initial staging or follow-up between January 2003 and December 2007. Of 741 NSCLC patients, 135 (18%) NSCLC patients were identified to have synchronous brain metastasis without associated symptoms. Of the 129 patients included in the analysis, 78 (57.8%) patients received systemic chemotherapy only, 27 (20.0%) upfront WBRT followed by chemotherapy and 24 (17.8%) patients received upfront SRS and chemotherapy. There was no significant difference in overall survival among three groups (systemic chemotherapy alone, 13.9 versus upfront SRS followed by chemotherapy, 22.4 versus upfront WBRT followed by chemotherapy, 17.7 months, respectively; P=0.86). Subset analysis of 110 adenocarcinoma patients showed that the median OS for patients treated with upfront SRS was longer than those of upfront WRBT (29.3 months versus 17.7 months; P=0.01) or chemotherapy alone (29.3 months versus 14.6 months; P=0.04). CONCLUSION: This study suggested a potential role of systemic chemotherapy alone or upfront SRS followed by chemotherapy instead of WBRT as an initial treatment of NSCLC patients with synchronous, asymptomatic brain metastases. The optimal treatment modality, however, needs to be defined in prospective trials for this subset of patients. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
BACKGROUND: The optimal treatment for non-small cell lung cancer (NSCLC) patients with asymptomatic brain metastasis is still controversial. This study aimed to analyze the outcome for various treatment modalities including chemotherapy only, upfront whole brain radiotherapy (WBRT) or stereotactic radiosurgery (SRS) in NSCLCpatients with asymptomatic brain metastases. METHODS: We retrospectively reviewed the medical records of patients with histopathologically proven NSCLC and synchronous asymptomatic brain metastasis between January 2003 and December 2007. RESULTS: From the database, 741 NSCLCpatients were identified to have been diagnosed of brain metastases during initial staging or follow-up between January 2003 and December 2007. Of 741 NSCLCpatients, 135 (18%) NSCLCpatients were identified to have synchronous brain metastasis without associated symptoms. Of the 129 patients included in the analysis, 78 (57.8%) patients received systemic chemotherapy only, 27 (20.0%) upfront WBRT followed by chemotherapy and 24 (17.8%) patients received upfront SRS and chemotherapy. There was no significant difference in overall survival among three groups (systemic chemotherapy alone, 13.9 versus upfront SRS followed by chemotherapy, 22.4 versus upfront WBRT followed by chemotherapy, 17.7 months, respectively; P=0.86). Subset analysis of 110 adenocarcinomapatients showed that the median OS for patients treated with upfront SRS was longer than those of upfront WRBT (29.3 months versus 17.7 months; P=0.01) or chemotherapy alone (29.3 months versus 14.6 months; P=0.04). CONCLUSION: This study suggested a potential role of systemic chemotherapy alone or upfront SRS followed by chemotherapy instead of WBRT as an initial treatment of NSCLCpatients with synchronous, asymptomatic brain metastases. The optimal treatment modality, however, needs to be defined in prospective trials for this subset of patients. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Authors: Chiara D'Antonio; Antonio Passaro; Bruno Gori; Ester Del Signore; Maria Rita Migliorino; Serena Ricciardi; Alberto Fulvi; Filippo de Marinis Journal: Ther Adv Med Oncol Date: 2014-05 Impact factor: 8.168
Authors: Ngoc H On; Ryan Mitchell; Sanjot D Savant; Corbin J Bachmeier; Grant M Hatch; Donald W Miller Journal: J Neurooncol Date: 2012-11-27 Impact factor: 4.130
Authors: Mariusz Jan Bella; Janusz Kowalewski; Maciej Dancewicz; Przemysław Bławat; Tomasz Jarosław Szczęsny; Aleksandra Chrząstek; Paweł Wnuk Journal: Kardiochir Torakochirurgia Pol Date: 2015-03-31