OUTCOME OF PATIENTS WITH BRAIN METASTASES AFTER COMBINED-MODALITY THERAPY IN SMALL-CELL LUNG-CANCER (SCLC) - A RETROSPECTIVE STUDY

The authors evaluated the role of whole brain radiotherapy (WBRT) on t he outcome of brain metastasis and survival in 41 patients with small cell lung cancer (SCLC) treated in their department. In addition to ch emotherapy, radiotherapy was given to the primary site in all responde r patients. Six patients presented brain metastasis initially and 10 p atients after the fourth course of chemotherapy. Brain metastases were symptomatic in 12 of 16 patients with a median time of 5 months (1-14 ) until symptoms developed. All patients but 2 with brain metastasis r eceived WBRT (30 Gy in 10 fractions) in addition to chemotherapy. The median survival time of patients with brain metastasis was 8.3 months (3.5 to 16) compared to 12 months (4 to 34+) for patients without brai n metastasis. In addition, the median survival time for patients with brain metastasis who responded to systemic chemotherapy was better tha n that of nonresponders, The authors found no improvement in survival in patients who received concomitant WBRT after chemotherapy compared to patients who received WBRT after completion of chemotherapy. In con clusion, the role of consolidating cranial irradiation in addition to chemotherapy in SCLC patients is unclear and warrants prospective rand omized studies.