IS IT TIME TO REEVALUATE OUR APPROACH TO THE TREATMENT OF BRAIN METASTASES IN PATIENTS WITH NONSMALL CELL LUNG-CANCER

Brain metastases from non-small cell lung cancer develop in approximat ely one-third of patients. If not treated, neurological deterioration occurs quickly. Treatment with whole brain irradiation is advisable to palliate symptoms but despite this treatment, survival remains poor a t 3-6 months. Recently, aggressive approaches with surgical resection and stereotactic radiosurgery have dramatically improved the control o f brain metastases resulting in a meaningful survival advantage for a subset of eligible patients. New evidence also suggests a possible rol e for chemotherapy in the treatment of brain metastases. With several options now available to treat brain metastases proper patient selecti on is needed. This article will stratify patients with brain metastase s and discuss the treatment modalities for each category. (C) 1998 Pub lished by Elsevier Science Ireland Ltd. All rights reserved.