title: Prophylactic cranial irradiation in non-small cell lung cancer patients: who might be the candidates?
abstract: OBJECTIVE
  Brain metastases (BMs) often advance the course of non-small cell lung cancer (NSCLC). We performed an observational study in order to investigate the possible correlation of selected clinical and epidemiological factors with BM appearance in patients suffering from different histological subtypes of NSCLC stage I-IV.
  
  
  METHODS
  The study included 161 consecutive patients with NSCLC. Analyzed data included patient- and tumor-related characteristics.
  
  
  RESULTS
  Thirty-nine patients (24.2%) presented BMs within 12 (0-36) weeks of diagnosis. BMs decreased the mean overall survival significantly (15.6 versus 50.7 weeks, P < 0.001), with hazard ratio (95% confidence interval) 3.60 (2.42-5.35). The age of the patients with BM was significantly lower than that of the patients without BM (60.8 ± 8.9 versus 66.5 ± 8.5, P < 0.001). Patients with BM had significantly higher pack-years consumption (75.9 ± 23.9 versus 58.9 ± 31.9, P = 0.003) and larger tumor size compared with patients without BM (size in mm: 55.1 ± 20.1 versus 45.9 ± 19.3, P = 0.012). The presence of BM was also correlated with the absence of lung (P < 0.001), bone (P = 0.005), and adrenal (P = 0.046) metastases.
  
  
  CONCLUSIONS
  Younger NSCLC patients with high tobacco consumption, large tumor size, and absence of metastases in other organs (lung, bones, adrenal metastases) are at high risk of BM appearance during the course of NSCLC and are candidates for prophylactic cranial irradiation early in the course of the disease.
authors.affiliation: 9th Respiratory Medicine Department, University of Athens Medical School, "Sotiria" Chest Diseases Hospital, Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Dimitropoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Hillas
authors.forename: Sofia
authors.initials: S
authors.lastname: Nikolakopoulou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Kostara
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Sagris
authors.forename: Fotis
authors.initials: F
authors.lastname: Vlastos
authors.forename: Manos
authors.initials: M
authors.lastname: Alchanatis