Effective Treatment of Recurrent Small Cell Lung Carcinoma Metastases to the Brain

Research conducted at the University of Virginia has explored the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain. The study, published in the Journal of Neurosurgery in 2009, involved a retrospective review of 27 patients who underwent radiosurgery. The results showed that tumor volume, preoperative Karnofsky Performance Scale score, and time between initial lung cancer diagnosis and development of brain metastasis significantly affected survival.

Key Takeaways:

• The study found that tumor volume was a significant prognostic factor, with a p-value of 0.0042.
• Preoperative Karnofsky Performance Scale score was also a significant factor, with a p-value of 0.0035.
• Time between initial lung cancer diagnosis and development of brain metastasis was a significant factor, with a p-value of 0.0127.
• Postradiosurgical imaging revealed that 62% of brain metastases decreased in size, 19% remained stable, and 19% increased in size.
• Stereotactic radiosurgery provided effective local tumor control in the majority of patients.
• The researchers concluded that early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.
• A total of 47 recurrent small cell lung cancer brain metastases were treated in the study.
• The median survival time after the diagnosis of brain metastases was 18 months.
• One patient underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy.
• Three patients developed new brain metastases on follow-up imaging.

Statistics:

• 50% of patients with small cell lung cancer develop a brain metastasis (see Small Cell Lung Cancer).
• Median survival for patients with small cell lung carcinoma metastasis to the brain is approximately 4-5 months after cranial irradiation.
• 62% of brain metastases decreased in size after postradiosurgical imaging.
• 19% of brain metastases remained stable after postradiosurgical imaging.
• 19% of brain metastases increased in size after postradiosurgical imaging.
• 47 recurrent small cell lung cancer brain metastases were treated in the study.
• 27 patients underwent radiosurgery in the study.
• 14 years were the duration of the treatment period collected from the patients.
• 18 months was the median survival time after the diagnosis of brain metastases.

Sources:

• Journal of Neurosurgery, Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: outcomes and prognostic factors. Journal of Neurosurgery, 2009;111(Suppl. S):147-154.
• Cancer Weekly via NewsRx.com, Copyright 2009.