[The treatment of brain metastasis from lung cancer]

From August, 1976, through May, 1986, 111 patients with brain metastasis from lung cancer received various treatments according to their systemic conditions. Forty-two out of 55 patients without systemic metastasis were selected for surgical removal followed by radiation therapy, and the remaining 13 inoperable patients received radiation therapy alone. The median survival of the former group was 14.5 months with a 1-year survival rate of 57.2%, and was 11.0 months with a 1-year survival rate of 38.1% for the latter group. Twenty patients among the former group received intraoperative radiation therapy, and the result obtained was the same as that of the remaining 22 patients treated by surgery and conventional external radiation therapy. As to the conservative therapy applied for the 47 cases with systemic metastasis, radiation therapy, surgical decompression or steroid therapy were planned. The overall median survival of patients of this group was 3.5 months, with a 6-month survival rate of 27.7%. Radiation therapy combined with cisplatin was evaluated to be effective, showing more than 50% reduction of tumor volume in 73.9% of patients. The surgical removal of metastatic tumors should be considered for patients without systemic metastasis, and should also be followed by radiation therapy. Such cases would be expected to survive for more than 1 year, whereas there is no suitable treatment for patients with systemic metastasis.