title: Systemic chemotherapy after cranial irradiation in patients with brain metastases from non-small cell lung cancer: a retrospective study.
abstract: BACKGROUND
  Brain metastases (BMs) are found in about 10% of patients with newly diagnosed non-small cell lung cancer (NSCLC). This retrospective study was conducted to assess the clinical outcomes and prognostic factors of patients who received chemotherapy after cranial irradiation for NSCLC with synchronous BMs.
  
  
  METHODS
  From January 2000 through July 2007, we reviewed the medical records of patients who received systemic chemotherapy following cranial irradiation for BMs from newly diagnosed NSCLC.
  
  
  RESULTS
  A total of 40 patients were included in this review. As the first-line chemotherapy, a total of 114 cycles were administered, for a median number of 2 cycles per patient (range, 0.5-8 cycles). Thirty-four patients (85%) received platinum-based combination regimen and the remaining 6 received chemotherapy with a single agent. Sixteen (40%) patients, 11 of whom had ECOG of 2, only received 1 cycle or less of chemotherapy due to early death, rapid progression, clinical impairment, or toxicity. For 28 patients who were evaluable for response, the extracranial overall response rate was 43%. The median overall survival for all patients was 7 months (range, 0.9-25.3 months) and an estimated 1-year survival rate was 23%. Multivariate analysis revealed that ECOG status (P=0.018) and number of BM (P=0.038) were independent prognostic factors.
  
  
  CONCLUSIONS
  Our results suggest that chemotherapy can be used to increase survival of patients treated with cranial irradiation for newly diagnosed NSCLC with synchronous BM. However, systemic chemotherapy should be carefully considered according to the patient's prognostic condition. Especially, patients with good performance status and limited number of BM may be good candidates for systemic chemotherapy after cranial irradiation.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Youngdungpo-Gu, Seoul, Republic of Korea. harricil@hotmail.com
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyeong Su
authors.initials: HS
authors.lastname: Kim
authors.forename: Jung Hye
authors.initials: JH
authors.lastname: Kwon
authors.forename: Sarah
authors.initials: S
authors.lastname: Park
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Jung
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hun Ho
authors.initials: HH
authors.lastname: Song
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
authors.forename: Soon Il
authors.initials: SI
authors.lastname: Lee
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Gong
authors.forename: Jung-Ae
authors.initials: JA
authors.lastname: Lee
authors.forename: Kyoung Ju
authors.initials: KJ
authors.lastname: Kim
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Zang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents