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Management and Prognosis in Synchronous Solitary Resected Brain Metastasis from Non–Small-Cell Lung Cancer
Clinical Lung Cancer
  • Alexander V. Louie, London Regional Cancer Program, London, ON
  • George Rodrigues, University of Western Ontario
  • Brian Yaremko, University of Western Ontario
  • Edward Yu, University of Western Ontario
  • A. Rashid Dar, University of Western Ontario
  • Brian Dingle, University of Western Ontario
  • Mark Vincent, University of Western Ontario
  • Michael Sanatani, University of Western Ontario
  • Richard Malthaner, University of Western Ontario
  • Richard Inculet, University of Western Ontario
Document Type
Article
Publication Date
5-1-2009
Disciplines
Abstract
Background: Reports in the medical literature have described cases of extended survival of patients with non-small-cell lung cancer (NSCLC) with solitary metastatic disease who have received aggressive treatment both to the brain metastasis and to the local/regional disease. The objective of this research is to analyze prognostic factors that predict for outcome in this unique patient population. Patients and methods: A single-institution, retrospective chart review was performed on 35 patients with NSCLC and a synchronous solitary brain metastasis (SSBM) treated with craniotomy and whole-brain radiation therapy. Eight patients (22.9%) had chest surgery, 24 (68.6%) had chemotherapy, and 14 (40%) had thoracic radiation as part of their local management. Fourteen had stage I/II disease (42.9%), and 20 had stage III disease (57.1%). Mean age at diagnosis was 58.5 years. Eighteen patients (56.25%) had a brain metastasis < 3 cm, and 14 patients (43.75%) had a metastasis > 3 cm. Results: Median survival was 7.8 months, and at last follow-up, 3 patients (8.6%) were alive and well, 6 patients (17.1%) were alive and with disease, 24 patients (68.6%) had died of disease, and 2 patients (5.7%) had died of other causes. Univariate analysis demonstrated that lung surgery (P = .0033), primary lung treatment > 8 weeks after brain surgery (P = .0128), and stage I/II disease (P = .0467) were predictive of overall survival. Conclusion: Survival remains poor for patients with NSCLC with an SSBM. However, patients with thoracic disease amenable to local resection should be considered for such therapy because a survival advantage could exist compared with patients with more locally advanced disease.
Notes
Published in: Clinical Lung Cancer, Volume 10, Number 3, May 2009, Pages 174-179. doi: 10.3816/CLC.2009.n.024
Citation Information
Alexander V. Louie, George Rodrigues, Brian Yaremko, Edward Yu, et al.. "Management and Prognosis in Synchronous Solitary Resected Brain Metastasis from Non–Small-Cell Lung Cancer" Clinical Lung Cancer Vol. 10 Iss. 3 (2009) p. 174 - 179
Available at: http://works.bepress.com/richard_malthaner/33/