Neurologic disorders in 432 consecutive patients with small cell lung carcinoma

Abstract

BACKGROUND Neurologic complications are an important cause of morbidity and possibly also mortality in patients with small cell lung carcinoma (SCLC). The current study was undertaken to prospectively investigate survival and the frequency of neurologic disorders in patients with SCLC. METHODS Between October 1980 and September 2001, 432 consecutive patients with microscopically proven SCLC were included in the current study. Patients underwent neurologic examinations on a regular basis prior to, during, and after treatment. Routine imaging of the brain (computed tomography or magnetic resonance imaging) was performed before and after systemic therapy. RESULTS A neurologic disorder was diagnosed in approximately 56% of the SCLC patients. In nearly half of the cases, the neurologic disorder already was present at the time of diagnosis. Brain metastases (BM) were diagnosed most frequently. Seventy‐four patients (18%) had BM at the time of diagnosis; in 20 of these patients, the BM did not demonstrate clinical signs. Another 101 patients developed BM during follow‐up. The 2‐year cumulative risk of BM reached 49% for patients with limited disease (LD) and 65% for patients with extensive disease (ED). Patients with BM as the only site of disease dissemination were found to have a poorer survival compared with LD patients. The majority of the nonmetastatic disorders preceded the diagnosis of SCLC. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) was diagnosed most frequently. CONCLUSIONS In this prospective study, neurologic disorders were diagnosed in greater than half of the patients with SCLC. BM were detected most frequently. Approximately 18% of the patients were found to have BM at the time of diagnosis. In approximately 33% of the cases, these BM did not cause symptoms. BM were found to have a negative effect on survival in patients with SCLC. Cancer 2004;100:801–6. © 2004 American Cancer Society.

Detection of brain metastases from small cell lung cancer

“…3 Dissemination to the brain is a frequently encountered complication of SCLC. 4,5 In the past 3 decades, estimates of the prevalence of brain metastases (BM) in SCLC patients have ranged from 10% to 18%. 4,[6][7][8] In our hospital, computed tomography (CT) was used for the diagnosis of BM from SCLC until 1991.…”

Medical Management of Brain Metastases from Lung Cancer

“…Approximately 18-25% of SCLC patients have brain metastases already at diagnosis, and an additional 50% will develop CNS involvement during their disease course (75)(76)(77). Although WBRT and corticosteroids are the treatment of choice, systemic chemotherapy may also have therapeutic value.…”

Medical management of brain metastases from lung cancer (Review)

“…50% will develop CNS involve-ment during their disease course (66)(67)(68). Although WBRT and corticosteroids are the treatment of choice, systemic chemotherapy may also have therapeutic value.…”