Chemotherapy for brain metastases in small-cell lung cancer.
OBJECTIVE
Brain metastasis occurs commonly in patients with small-cell lung cancer (SCLC). Herein, we report the efficacy of irinotecan and carboplatin in the treatment of brain metastases from SCLC. In addition, we review the existing data on chemotherapy for brain metastases in SCLC.


METHODS
Eighty patients with metastatic or relapsed SCLC were enrolled in a phase II trial of irinotecan and carboplatin. Patients naive to chemotherapy were treated with irinotecan 200 mg/m2 and carboplatin AUC of 5, and patients previously treated with chemotherapy received irinotecan 150 mg/m2 and carboplatin AUC of 5, every 21 days for 6 cycles.


RESULTS
Among the 80 patients, 15 (19%) presented with brain metastases. An analysis of 14 assessable patients with brain metastases revealed an overall response rate of 65% after 2 cycles of chemotherapy and a median survival of 6 months (range, 1-24 months). Upon review of the literature, 8 studies were identified as having > 10 patients who received chemotherapy for brain metastases from SCLC. Based on these studies, the response rate of brain metastases from SCLC to a variety of chemotherapy and median survival of patients ranged from 22% to 85% and 3 months to 9 months, respectively.


CONCLUSIONS
Chemotherapy, including the regimen of irinotecan and carboplatin, is an effective treatment for SCLC brain metastases.
Chen
Gigi
G
University of California, Davis Cancer Center and Northern California VA Health System, Sacramento 95817, USA.
Huynh
Minh
M
Chen
Allan
A
Fehrenbacher
Lou
L
Gandara
David
D
Lau
Derick
D
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001812:Blood-Brain Barrier; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016190:Carboplatin / Q000008:administration & dosage*; D018288:Carcinoma, Small Cell / Q000473:pathology*; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged
D000077146:Irinotecan; D016190:Carboplatin; D002166:Camptothecin