Management of nonsmall cell lung carcinoma with solitary brain metastasis

Read, Raymond C.; Boop, Warren C.; Yoder, Gordon; Schaefer, Robert F.

doi:10.1016/s0022-5223(19)34267-9

Cited by 68 publications

(15 citation statements)

References 20 publications

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“…On first review, the data presented in this report do not support aggressive therapy. The median survival for the entire group is only 6.9 months, and this does not compare well with previously published series of patients with brain metastases from lung cancer [15][16][17][18][19]22]. The drawback of most of these studies is the lack of clarity regarding which patients are being reported, as most included patients with metachronous presentations [15][16][17]19,22], multiple brain metastases [16,19,22], or extracranial systemic disease [19,22].…”

Section: Discussioncontrasting

confidence: 57%

“…Despite the short median survival reported in this review, the conclusion that patients with Stage IV NSCLC with an isolated, single, synchronous brain metastasis should be treated with strictly palliative measures must only be made with caution. A review of the literature reveals survival among comparable patients ranging from as low as 6.4 months up to 18 months [15][16][17][18][19]22,23]. It should be noted that most reports consist of series of patients that have received aggressive therapy for the primary tumor, whereas most patients in the current series were treated in a palliative manner.…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that most reports consist of series of patients that have received aggressive therapy for the primary tumor, whereas most patients in the current series were treated in a palliative manner. In addition, these reports have noted significantly longer survival among patients who underwent potentially curative resection of the primary tumor [15][16][17]19,22], which suggests that a synchronous brain metastasis does not contraindicate aggressive therapeutic approaches for patients with NSCLC.…”

Section: Discussionmentioning

confidence: 99%

“…As improvements are made in the management of brain metastases, the question arises of how to manage patients who have newly diagnosed lung cancer and an isolated single brain metastasis. Although most reports show that a synchronous presentation is a poor prognostic finding, the use of aggressive surgery for both the primary tumor and the brain metastases has produced encouraging results [15][16][17][18][19]. In an effort to clarify such conflicting data and identify patients who may benefit from aggressive management, we reviewed the outcome of 33 patients treated for primary nonsmall-cell lung cancer (NSCLC) with an isolated, single, synchronous brain metastasis.…”

Section: Introductionmentioning

confidence: 99%

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Treatment outcome for patients with primary nonsmall-cell lung cancer and synchronous brain metastasis

Chidel

Suh

Greskovich

et al. 1999

Radiat. Oncol. Investig.

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The purpose of this study was to evaluate the outcome of treatment for patients with newly diagnosed nonsmall‐cell lung cancer (NSCLC) with an isolated, single, synchronous brain metastasis. A retrospective review was performed evaluating any patient diagnosed between 1982 and 1996 at the Cleveland Clinic Foundation with NSCLC metastatic only to the brain. Patients with multiple brain metastases or with systemic metastases to any other organ were excluded. Survival was measured from the date of the first treatment for malignancy. All hospital records were thoroughly reviewed in a retrospective manner. Thirty‐three patients were identified who met the study criteria. Twelve patients had primary disease limited to the lung and hilar nodes, and 21 had more advanced primary disease with involvement of the mediastinum. Treatment of the chest was considered aggressive in 13 patients and palliative in 15. The primary tumor was observed in 5 patients. The management of the brain metastasis was as follows: 21 patients underwent surgical resection and postoperative whole brain radiotherapy (WBRT), 5 underwent stereotactic radiosurgery (SRS) and WBRT, 3 had resection alone, 2 had SRS alone, and 2 underwent WBRT alone. The median overall and disease‐free survival for all patients was 6.9 months and 3.3 months, respectively. Overall survival was markedly improved with the addition of WBRT (P = 0.002) and with the aggressive management of the primary tumor (P = 0.005). A total of 9 patients experienced CNS failure, including both patients receiving WBRT alone. CNS failures were divided as follows: 3 local, 5 distant, and 1 local and distant. Two of the 4 patients with a local failure were salvaged, and ultimate local control of the original brain metastasis was achieved in 93.6% of cases. Survival remains poor for patients with Stage IV NSCLC even when metastatic disease is limited to a single site within the brain; however, aggressive therapy of both the lung primary and the brain metastasis may provide a survival advantage. Excellent local control of single brain metastases was achieved with a combination of WBRT with either surgical resection or SRS. Radiat. Oncol. Invest. 7:313–319, 1999. © 1999 Wiley‐Liss, Inc.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment outcome for patients with primary nonsmall-cell lung cancer and synchronous brain metastasis

Chidel

Suh

Greskovich

et al. 1999

Radiat. Oncol. Investig.

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“…Metastatic disease in patients with bronchogenic carcinoma is considered a poor prognostic sign [ 11, and surgical treatment is therefore seldom recommended. Although some case reports have appeared on surgical resection of distant metastatic lesions such as solitary brain metastasis [2,3], reports on cases of resection of adrenal metastatic lesions are rare. This paper reports the surgical treatment of three patients with adrenal metastasis, two of whom are long-term survivors, and discusses the diagnosis of adrenal metastasis from lung cancer and the usefulness of surgical management.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of adrenal metastasis from bronchogenic carcinoma

Ayabe

Tsuji

Hara

et al. 1995

Journal of Surgical Oncology

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Surgical treatment for metastatic lesions from lung cancer is seldom performed. We have treated three patients with a unilateral adrenal metastasis with adrenalectomy. Simultaneous resection of primary lung cancer and adrenal metastasis was performed in two cases. This is the first report of such surgical management. Adrenalectomy after lung resection was done in the third case. Two of the patients are alive and well more than 5 years after adrenalectomy. These cases are presented, and the literature is reviewed.

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Surgical treatment of metastatic brain tumors

Lang

Sawaya

1998

Semin. Surg. Oncol.

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Key elements in the modern surgical treatment of metastatic brain tumors are a firm grasp of criteria for selection of proper surgical candidates and a thorough grounding in the surgical approaches to, and the anatomy of, cerebral metastases. It is important to realize that the presence of multiple or recurrent brain metastases does not automatically contraindicate surgery because in properly selected patients, resection of multiple metastases or reoperation for recurrent metastases can extend survival and enhance the quality of life. Appropriate treatment of metastatic brain tumors frequently requires the judicious use of modalities such as open craniotomy, whole brain radiotherapy, and stereotactic radiosurgery. In order to assure the best outcome of patients with cerebral metastases, it is necessary to have an awareness of how these modalities can best complement one another and to apply them accordingly. Semin. Surg. Oncol. 14:53–63, 1998. © 1998 Wiley‐Liss, Inc.

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Management of nonsmall cell lung carcinoma with solitary brain metastasis

Cited by 68 publications

References 20 publications

Treatment outcome for patients with primary nonsmall-cell lung cancer and synchronous brain metastasis

Treatment outcome for patients with primary nonsmall-cell lung cancer and synchronous brain metastasis

Surgical management of adrenal metastasis from bronchogenic carcinoma

Surgical treatment of metastatic brain tumors

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