Incidence and patterns of isolated brain failure in stage III non-small-cell lung cancer treated with concurrent chemoradiation therapy.
OBJECTIVE
The incidence and patterns of isolated brain failure was examined in patients with stage III non-small-cell lung cancer (NSCLC) treated with concurrent chemoradiation (CCRT).


METHODS
Between 1996 and 2003, a total of 68 patients with stage III NSCLC were treated with radical CCRT. Among them, 63 patients were evaluable. Radiation therapy with a mean total dose of 61.4 Gy and chemotherapy (typically platinum-based) were administered concurrently.


RESULTS
Other than locoregional failure, isolated brain failure was the most common failure pattern as the initial failure, occurring 2-37 months (median 6.5 months) after radical CCRT. The isolated brain failure rates as the initial failure at 1, 3, and 4 years were 9%, 13%, and 25%, respectively. Isolated brain failure as the initial failure occurred more frequently in T4 cases (39% at 4 years) compared to T1-3 cases (14% at 4 years) in our series (P = 0.0099).


CONCLUSIONS
Except for locoregional failure, isolated brain failure was the most common initial failure pattern of stage III NSCLCs treated with radical CCRT. Isolated brain failure as the initial failure occurred even after 3 years. Isolated brain failure as the initial failure occurred more frequently in T4 cases than in T1-3 cases.
Department of Radiology, Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama, 791-0280, Japan. yhamamot@shikoku-cc.go.jp
Yasushi
Y
Hamamoto
Masaaki
M
Kataoka
Takatoshi
T
Senba
Kotaro
K
Uwatsu
Shogo
S
Oda
Tadaaki
T
Takahashi
Shoji
S
Aono
Shinya
S
Sakai
Takeshi
T
Inoue
Yoshifumi
Y
Sugawara
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001921:Brain / Q000503:physiopathology*; D001927:Brain Diseases / Q000209:etiology / Q000503:physiopathology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology; D009367:Neoplasm Staging; D012189:Retrospective Studies