title: Evaluation of late neurologic adverse events in patients with brain metastases from non-small cell lung cancer.
abstract: OBJECTIVE
  The purpose of this prospective evaluation was to assess the late neurologic adverse events and Karnofsky performance status (KPS) in patients with at least two brain metastases from non-small cell lung cancer treated with whole-brain radiotherapy (WBRT) with or without sequential systemic chemotherapy.
  
  
  METHODS
  All patients were required to have an initial KPS of at least 70%. During the first six months, the patients were re-examined every four weeks, later every 3 months or whenever the clinical condition worsened. Due to slow accrual, the protocol was closed prematurely in 2005. Sixteen adult patients (median age 56 years) treated with 10x3 Gy were studied.
  
  
  RESULTS
  Late adverse events > or = grade 2 (CTC AE v3.0) in imaging-confirmed absence of progressive brain metastases developed in 3 patients after a median of 5 months. With a median overall survival of 7 months, the actuarial risk of late adverse events at that time was 0% after WBRT alone and 37% after WBRT and chemotherapy. Thus, larger studies assessing the impact of multimodal treatment are recommended.
authors.affiliation: Department of Internal Medicine - Oncology, Radiation Oncology Unit, Nordlandssykehuset HF, Bodø, Norway. carsten.nieder@nlsh.no
authors.forename: Carsten
authors.initials: C
authors.lastname: Nieder
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Astner
authors.forename: Anca-Ligia
authors.initials: AL
authors.lastname: Grosu
authors.forename: Michael
authors.initials: M
authors.lastname: Molls
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D013534:Survival; D016896:Treatment Outcome