title: Management of brain metastases from non-small cell lung cancer.
abstract: OBJECTIVE
  The purpose of the following study is to evaluate the treatment modalities, clinical status and prognostic factors affecting survival rates in patients with newly diagnosed brain metastasis from non-small cell lung cancer (NSCLC).
  
  
  METHODS
  NSCLC patients with a new diagnosis of one to four brain metastasis evaluated retrospectively for the effects of treatment regimens on local failure-relapse-free survival (LRFS) and overall survival (OS). The relationship between age, gender, performance status, recursive partitioning analysis (RPA) classification, the primary tumor under control, number of metastatic tumors in the brain and total volume of brain metastasis and prognosis is analyzed.
  
  
  RESULTS
  Out of a total of 138 (121 male and 17 female) patients, nearly 44.2% received only gamma-knife (GK); 24.6% were received both GK and whole brain radiotherapy (WBRT), 2.9% had GK and surgery, 3.6% received GK, surgery and WBRT, 10.9% had surgery and WBRT and 12.3% received only WBRT for treatment. Median LRFS of surgery plus WBRT group was significantly higher when compared with WBRT group (P<0.0001). The OS was significantly longer for surgery plus WBRT group than the other treatment groups (P=0.037). When median survival of WBRT-only group compared with surgery plus WBRT, it was significantly higher (29.6 months vs. 16.7 months, P=0.006). Median OS of surgery plus WBRT group was significantly higher than GK plus WBRT group (29.6 months vs. 9.3 months, P=0.007).
  
  
  CONCLUSIONS
  WBRT is still the most effective treatment method following surgery in selected patients according to their age, performance status and spread of the primary disease with NSCLC had limited number brain metastasis. Adding WBRT treatment after surgery significantly improved OS and LRFS.
authors.affiliation: Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Baykara
authors.forename: Gokhan
authors.initials: G
authors.lastname: Kurt
authors.forename: Suleyman
authors.initials: S
authors.lastname: Buyukberber
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Necdet
authors.initials: N
authors.lastname: Ceviker
authors.forename: Efnan
authors.initials: E
authors.lastname: Algin
authors.forename: Ugur
authors.initials: U
authors.lastname: Coskun
authors.forename: Sukru
authors.initials: S
authors.lastname: Aykol
authors.forename: Hakan
authors.initials: H
authors.lastname: Emmez
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozet
authors.forename: Mustafa
authors.initials: M
authors.lastname: Benekli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011379:Prognosis; D016634:Radiosurgery; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome