Efficacy of Surgical Treatment for Brain Metastasis in Patients with Non-Small Cell Lung Cancer

• Published in: Yonsei medical journal Vol. 56; no. 1; pp. 103 - 111
• Main Authors: Kim, Sang Young, Hong, Chang Ki, Kim, Tae Hoon, Hong, Je Beom, Park, Chul Hwan, Chang, Yoon Soo, Kim, Hyung Jung, Ahn, Chul Min, Byun, Min Kwang
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.01.2015; 연세대학교의과대학
• Subjects: Adult; Aged; Aged, 80 and over; Brain Neoplasms - physiopathology; Brain Neoplasms - secondary; Brain Neoplasms - surgery; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Demography; Disease-Free Survival; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Lung Neoplasms - pathology; Male; Middle Aged; Original; Treatment Outcome; 의학일반; brain metastasis; neurosurgery; quality of life; treatment outcome; Non-small cell lung cancer
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2015.56.1.103

Patients with non-small cell lung cancer (NSCLC) and simultaneously having brain metastases at the initial diagnosis, presenting symptoms related brain metastasis, survived shorter duration and showed poor quality of life. We analyzed our experiences on surgical treatment of brain metastasis in patients with NSCLC. We performed a single-center, retrospective review of 36 patients with NSCLC and synchronous brain metastases between April 2006 and December 2011. Patients were categorized according to the presence of neurological symptoms and having a brain surgery. As a result, 14 patients did not show neurological symptoms and 22 patients presented neurological symptoms. Symptomatic 22 patients were divided into two groups according to undergoing brain surgery (neurosurgery group; n=11, non-neurosurgery group; n=11). We analyzed overall surgery (OS), intracranial progression-free survival (PFS), and quality of life. Survival analysis showed there was no difference between patients with neurosurgery (OS, 12.1 months) and non-neurosurgery (OS, 10.2 months; p=0.550). Likewise for intracranial PFS, there was no significant difference between patients with neurosurgery (PFS, 6.3 months) and non-neurosurgery (PFS, 5.3 months; p=0.666). Reliable neurological one month follow up by the Medical Research Council neurological function evaluation scale were performed in symptomatic 22 patients. The scale improved in eight (73%) patients in the neurosurgery group, but only in three (27%) patients in the non-neurosurgery group (p=0.0495). Patients with NSCLC and synchronous brain metastases, presenting neurological symptoms showed no survival benefit from neurosurgical resection, although quality of life was improved due to early control of neurological symptoms.