Médecine pulmonaire et respiratoire

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.