title: Pulmonary resection in patients with nonsmall-cell lung cancer treated with gamma-knife radiosurgery for synchronous brain metastases.
abstract: BACKGROUND
  The aim of the current study was to determine whether a pulmonary resection and gamma-knife radiosurgery (GKRS) protocol is superior to GKRS alone in selected patients with stage IV nonsmall-cell lung cancer (NSCLC).
  
  
  METHODS
  The authors performed a retrospective case-control study of 232 consecutive patients with newly diagnosed NSCLC from January 1998 to December 2005 and screened them to identify a study cohort in which all patients had thoracic stage I or II, Karnofsky performance status >or= 70, no extracranial metastases, and 1-3 synchronous brain metastases of less than 3 cm, and were treated with GKRS (n=31). The study cohort was divided into 2 groups, those with and without concomitant pulmonary resection.
  
  
  RESULTS
  Sixteen patients with pulmonary resection were assigned to the treatment group and 15 without pulmonary resection were assigned to the control group. Median follow-up was 27.3 months (range, 4.4 months to 90.9 months). Mean survivals for the treatment group and the control group were 64.9 and 18.1 months, respectively (P< .001). There was a statistically significant association between pulmonary resection and better survival (OR=78.408). One-year and 5-year local brain tumor control rates were 97.1% and 93.5%, respectively.
  
  
  CONCLUSIONS
  The pulmonary resection and GKRS protocol could prolong survival in patients with thoracic stage I or II NSCLC, no extracranial metastases, and a limited number of small synchronous brain metastases.
authors.affiliation: Department of Neurosurgery, DongGuk University International Hospital, Gyeonggi-do, Korea.
authors.forename: Seung-Yeob
authors.initials: SY
authors.lastname: Yang
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Hyun-Tai
authors.initials: HT
authors.lastname: Chung
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek
authors.forename: Joo
authors.initials: J
authors.lastname: Hyun Kim
authors.forename: Hee-Won
authors.initials: HW
authors.lastname: Jung
authors.forename: Dae Hee
authors.initials: DH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary / Q000601:surgery*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011013:Pneumonectomy / Q000379:methods*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D002945:Cisplatin