COMPARISON OF CLINICAL NEUROLOGICAL FUNCTION AND CT RESPONSE DURING CHEMOTHERAPY FOR INITIAL BRAIN METASTASES FROM SMALL-CELL LUNG-CANCER

We compared the clinical neurological and functional response with cha nges in CT during systemic combination chemotherapy in 20 patients wit h initial brain metastases from small cell lung cancer (SCLC). Seven p atients died within four weeks from start of chemotherapy, leaving 13 patients for evaluation of treatment response. Eight patients improved to or maintained a high neurological score, meaning no or insignifica nt neurological deficits or disability. Three patients had a stable ne urological score, and 2 patients deteriorated. The median duration of the clinical response was 20 weeks. Based on changes in CT four patien ts had complete remission, six had partial remission, and two showed n o change. One patient had a rapid deterioration of her clinical condit ion and died without CT control. Five patients with late CNS relapse w ere treated with second-line cranial irradiation inducing clinical imp rovement in three. Median survival was 11 weeks, and in assessable pat ients, excluding early deaths, 28 weeks. In conclusion initial brain m etastases respond to systemic chemotherapy as readily as extracranial locations of SCLC, and in many patients prolonged neurological and CT remission can be achieved.