RADIOTHERAPY PLUS CARBOPLATIN AND TENIPOSIDE IN PATIENTS WITH BRAIN METASTASES FROM NON-SMALL-CELL LUNG-CANCER

Background. The role of chemotherapy alone or added to radiation treat ment for the palliation of multiple, unresectable brain metastases fro m non small cell lung cancer (NSCLC), is not yet well defined. Carbopl atin and teniposide, however, are an interesting combination in this s etting since they are active in NSCLC and because of encouraging resul ts against brain metastases in other tumor types. Methods. Twenty pati ents with brain metastases from NSCLC were treated with whole brain ir radiation (total dose of 45 Gy) and chemotherapy (carboplatin, 300 mg/ sm on day 1 and teniposide, 60 mg/sm on days 1, 2 and 3). Results. Nin e patients (45%) showed a complete remission of neurologic symptoms, a nd 7 (35%) an improvement. Neurologic signs disappeared in 8 patients (40%) and improved in 7 (35%). Three patients (15%) had partial (50%) regression of brain metastases at CT scan, and also showed response in other tumor sites. One other patient had a response of chest and live r lesions while the cerebral metastases remained stable. Median surviv al was 7 months with a range of 1-9 months. Toxicity was mild, with no toxic deaths. Conclusions. Aggressive treatment can be taken into con sideration also in the case of NSCLC patients with brain metastases an d negative prognostic features. Their participation in clinical trials should be encouraged, since this will allow definition of the contrib ution of combined radiotherapy, chemotherapy and supportive care to th e quality and duration of the patient's life.