Improved quality of life of patients with small-cell carcinoma of the lung by elective irradiation of the brain.

About 30% of all patients with small cell undifferentiated carcinoma of the lung will ultimately develop metastases in the brain. It is now well established that elective whole brain irradiation can prevent such metastases, although it does not increase survival time. However, we have found that such treatment does increase the quality of life for these patients. Those with limited disease can survive with a Karnofsky scale of more than 60 for a mean time of 10 months compared with 6 months for an equivalent group treated only when these brain metastases occur. We have also found that treating patients therapeutically does not insure success as 6/16 eventually relapsed in the brain. We conclude that elective brain irradiation in patients with small cell undifferentiated carcinoma of the lung who present with a limited disease is of value because the quality of life is improved significantly.