J Korean Med Sci.  2006 Jun;21(3):527-532. 10.3346/jkms.2006.21.3.527.

Prognosis of Non-Small Cell Lung Cancer with Synchronous Brain Metastases Treated with Gamma Knife Radiosurgery

• Kong DS
• Lee JI
• Nam DH
• Park K
• Kim JH
• Kim JG
• Park JO
• Park K

• KMID: 1778439
• DOI: http://doi.org/10.3346/jkms.2006.21.3.527

Abstract

The clinical outcome and prognostic factors of patients with synchronous brain metastases from non-small cell lung cancer (NSCLC) who were treated with gamma knife radiosurgery (GKS) were analyzed. A total of 35 patients with NSCLC underwent GKS as an initial treatment for metastatic brain lesions of synchronous onset. The period of survival and various prognostic factors such as age, gender, performance status, multiplicity of the brain lesions, intracranial tumor volume, and extent of the primary tumor were analyzed. The overall median survival time for this series was 12 months (range 0.75 to 43 months) from the diagnosis. Of the 21 patients who were no longer alive at the conclusion of this study, only 7 (33.3%) died of neurological causes. Multivariate analysis of these data revealed that N stage, whole-brain radiotherapy (WBRT), and chemotherapy were significant predictors for survival (p<0.05). Survival of patients with NSCLC and synchronous brain metastases is mainly dependent upon the progression of the systemic disease, provided that the cerebral lesions are treated adequately with local treatment modalities including radiosurgery. Application of radiosurgery as an initial treatment option and aggressive local and systemic modalities to control extracranial disease may improve survival.

Keyword

Carcinoma, Non-Small-Cell Lung; Neoplasm Metastasis; Radiosurgery

MeSH Terms

Treatment Outcome
Time Factors
Radiosurgery/*methods
Prognosis
Neoplasm Metastasis
Middle Aged
Male
Lung Neoplasms/*diagnosis/pathology/*surgery
Humans
Female
Carcinoma, Non-Small-Cell Lung/*diagnosis/pathology/*surgery
Brain Neoplasms/*diagnosis/pathology/*surgery
Aged, 80 and over
Aged
Adult

Figure

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  Fig. 1 Overall survival time from the diagnosis of the brain metastases in the 35 patients who underwent gamma knife surgery.

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  Fig. 2 Survival time according to the N status of the primary lung cancer. The survival time is significantly shorter in those patients with a later N status.

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  Fig. 3 Survival time according to the systemic chemotherapy. Patients who received chemotherapy show longer survival time significantly than those who did not.

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  Fig. 4 Survival time according to the whole brain radiotherapy. Longer survival is shown in patients who underwent WBRT+GKS than those who did GKS only.

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  Fig. 5 Survival time according to the number of brain lesions. Survival tended to be shorter in patients with four or more lesions, but the difference did not achieve statistical significance.

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