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S. Sarıhan
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-035 - The Survival Effect of Resection of Cranial Metastatic Lesions in Patients with Lung Cancer (ID 3178)
09:30 - 09:30 | Author(s): S. Sarıhan
- Abstract
Background:
The brain is one of the organs where lung cancer often metastasizes. At the time of diagnosis, the central nervous system metastases are present in approximately 10% of lung cancer cases. 80-85% of them are located supratentorially, and 10-15% of supratentorial lesions are located on cerebellar regions. Median survival is 1-2 months from the time of diagnosis without treatment. A general consensus about standard treatment could not be provided in lung cancer with a single brain metastasis; but distant metastases should necessarily be controlled with surgery or stereotactic radiation therapy.
Methods:
74 patients (65 men and 9 women) were included in the study and evaluated retrospectively. They were followed in the department of medical oncology, school of medicine, Uludag University. All the patients had cranial operations for cranial metastases between 2004 and 2012. The ages and the first symptoms of the patients at the time of diagnosis, tumor localizations, surgical procedures, chemotherapy and radiotherapy protocols and histologic subtypes of lung cancer were analyzed. Time from diagnosis of cranial metastases to death was estimated as overall survival.
Results:
The symptoms of the patients at the time of diagnosis were as follows: 21 (28%) headache, 17 (23%) hemiparesis, 18 (24%) more than one neurologic symptoms, 8 (10%) seizure, and 8 (10%) imbalance. The distrıbution of histologic subtypes of patients was as follows: 42 (56%) adenocarcinoma, 17 (23%) squamous cell carcinoma, 14 (14%) small cell carcinoma, and 1 (1%) large cell carcinoma. According to surgical procedures, patients are distributed as follows: 68 (92%) total resection, 4 (5%) subtotal resection, and 2 (3%) stereotactic biopsy. 55 (74%) patients received cranial radiotherapy postoperatively. 15 (20%) patients received radiotherapy for both cranium and lung. 3 (4%) patients did not received radiotherapy. 1 patient’s information about radiotherapy could not be reached. 70 (95%) patients received platinum-based chemotherapy. 4 ()patients did not receive any chemotherapy regimens. Median overall survival was 12 months (1-110 months) in patients with cranial metastases.
Conclusion:
In an article examining brain metastases that were developed postoperatively, 65 patients were evaluated. 5-year survival in this group of patients was 15%. In that study, factors that affect survival positively, were listed as: female gender, adenocarcinoma histologic subtype, presence of limited number of metastases (1-2), no other extra thoracic metastases except brain metastases, stereotactic, radiologic and/or surgical treatment for metastases. However, in the literature it was reported that three cases, whose brain metastases appeared after surgical resection of lung cancer, had overall survival over 12 years with stereotactic radiotherapy. On the other hand, it is obvious that systemic therapy is so important for metastatic patients. The benefits of the combined treatment with surgery were studied by many groups. Although the studies have not identified the prognostic factors for survival exactly and either responded which group of patients could see more benefit from aggressive treatment yet; good results have been taken by adding surgical resection of metastases to combined treatment in especially selected patients.
