Combination chemotherapy of cisplatin, ifosfamide, and irinotecan with rhG-CSF support in patients with brain metastases from non-small cell lung cancer

Background: Brain metastases develop frequently in patients with non-small cell lung cancer (NSCLC), and the prognosis for these patients is very poor . We evaluated the role of chemotherapy for patients with brain metastases from NSCLC. Methods: We analyzed 30 patients who were discovered to have br ain metastases during the diagnosis of 121 patients enrolled in three conse cutive clinical trials on advanced NSCLC assessing combination chemotherapy of cisplatin, ifosfamide and irinotecan with rhG-CSF support. Response in the brain lesions was evaluated by contrast-enhanced MRI scans after at lea st two courses. Results: Fourteen patients achieved a partial response (PR) but there was no change (NC) in 13 patients and progressive disease (PD) i n 1. Among patients with extracranial lesions, 18 had a PR and 11 had NC. T he response rate in brain metastases was 50.0%, and that in extracranial pr imary and metastatic lesions was 62.1%, The median duration of response for intra-and extracranial lesions was 140 and 147 days, respectively. After c ompleting chemotherapy, Gamma Knife radiosurgery was performed on 2 patient s in remission and 8 patients at disease progression. The median survival t ime and 1-year survival rate were 382 days and 56,1%, respectively. Conclus ions: Both the response rate and survival data in this retrospective study suggest a high degree of activity of this combination chemotherapy in patie nts with brain metastases from NSCLC. Copyright (C) 2000 S, Karger AG. Base l.