Medicina Pulmonar e Respiratória

Aggressive Treatment of Brain Metastasis Increases Survival in Patients with Lung Cancer

Abstract

Peter Hatlen, Tore Amundsen, Sveinung Sørhaug, Håkon Leira, Müller Tomm B, Ruby Mahesparan and Harald H Hjelde

Introduction: In selected patients superior survival has been observed when treated aggressively for lung cancer and brain metastasis (BM). The aim of the study was to evaluate treatment-modalities and survival in our region retrospective.

Method: Retrospectively we compared survival for lung cancer patients treated either with microsurgery or Gamma knife surgery (GKS) for BM to a control group (N=510) patients with lung cancer stage IV and a mean age of 68 years.

Results: 42 patients with non-small cell lung cancer were included, 22 (52%) treated with microsurgery and 20 (45%) with GKS for BM. Patients treated aggressively for lung cancer and BM had a significant survival-benefit, 21 months (CI 95%: 9.4-32.6) vs. 4 months in the control group (CI 95%: 3.5-4.5) (p<0.001). Treatment with microsurgery showed a survival-benefit compared to GKS, 33 months (CI 95%: 15.7-50.2) vs. 15 months (CI 95%: 6.0-23.9). A later onset of BM was associated with a survival-benefit 24.6 months (CI 95%: 18.6-30.6) vs. 10.2 months (CI 95%: 4.4-16.1). Prognostic factors were age and the number of BM however patients with 3-4 BM had still a survival benefit (20% 2 years survival) compared to stage IV.

Conclusion: Lung cancer patients with BM, also more than 1, show a significant better overall survival after receiving aggressive BM treatment. The size of the BM seems to be less important.