[Whole-brain radiotherapy combined with COAPC regimen in patients with non-small cell lung cancer].
OBJECTIVE
The main treatment strategy of cancer patients with brain metastases was irradiation; while so far there were few researches concerning chemotherapy combined with radiotherapy for these patients. This study was designed to observe the therapeutic effect, toxicity, and survival of concurrent whole-brain radiotherapy (WBRT) combined chemotherapy with COAPC regimen in non-small cell lung cancer (NSCLC) patients with brain metastases.


METHODS
A total of 45 NSCLC patients with brain metastasis received a course of COAPC regimen [cyclophosphamide 0.3 mg/m(2) i.v. d(1), vincristine 1.4 mg/m(2) i.v. d(1), doxorubicin 50 mg/m(2) i.v. d(1), cisplatin 20 mg/m(2) i.v. d(1-5), semustine 80 mg/m(2) PO d(1)] every 3-4 weeks. Whole-brain radiotherapy was administered on day 6 of the first course of chemotherapy using (60)Co at a dose of 2 Gy given in 5 fractions per week. Patients with brain lesions of 1-3 received WBRT at a dose of 40 Gy and then small field to a total dose of 60 Gy. Patients with brain lesions of more than 3 received WBRT at a total dose of 40 Gy.


RESULTS
The treatment improved neurological symptoms in 80% of the patients. The response rates to brain lesions and primary lesions were 64.4% and 40.0%, respectively. The median survival time (MST) was 10 months. The 1-year and 5-year survival rates were 44.1% and 6.7%, respectively. The MST in the patients with brain metastasis was only 14 months,which was longer than the MST of 9 months in the patients with other metastasis sites(P=0.012).


CONCLUSIONS
Concurrent WBRT and chemotherapy can be safely preformed for the patients with brain metastasis from NSCLC with a remarkable response rate and encouraging survival duration.
Chen
Li-Kun
LK
Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Xu
Guang-Chuan
GC
Liu
Guo-Zhen
GZ
Liang
Ying
Y
Liu
Jun-Ling
JL
Zhou
Xian-Mei
XM
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000532:radiotherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use*
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin