BRAIN METASTASES FROM LUNG AND BREAST-CAN CER - DIFFERENCES IN PATTERNS OF SPREAD AND PROGNOSIS

Evaluation of 135 cases with brain metastases from non-small-cell lung cancer (group 1) compared with 51 cases from small-cell lung cancer ( group 2) and 56 cases from breast cancer (group 3) showed that the fre quency of solitary metastases was significantly higher in group 1 and 3. However, in group 2 lesions without surrounding edema occurred more frequently. The rate of patients with extracerebral metastases was si gnificantly higher in groups 2 and 3. The longest median interval betw een primary tumor and brain metastases was observed in breast cancer p atients. The highest local remission rate was seen in small-cell lung cancer if patients who received whole-brain irradiation of 30 Gy alone were compared (63 % vs 45 % in group 1 and 52 % in group 3). However, with regard to clinical course no significant differences were record ed. Survival of lung cancer cases was similar, whereas breast cancer c ases survived significantly longer, both after radiotherapy alone and after surgery plus radiotherapy. This might be caused by differences i n the natural course of the two diseases as well as adjuvant treatment modalities like hormone and chemotherapy. In conclusion, because long -term survivors were observed only in the breast cancer group, these p atients probably have the highest chance of profiting from a locally a ggressive treatment approach.