Proceedings: Frequency, diagnosis, and treatment of brain metastases in 247 consecutive patients with bronchogenic carcinoma.

Abstract

In a series of 247 consecutive patients with bronchogenic carcinoma treated with radiotherapy and/or chemotherapy, the over-all frequency of metastasis to the brain was 22.7%. These metastases were seen in 30.5% of patients with small cell carcinoma, 29.4% of patients with large cell anaplastic carcinoma, 25.4% of patients with adenocarcinoma, and 13.7% of patients with epidermoid carcinoma. Eighty percent of the brain metastases were diagnosed antemortem. Treatment included corticosteroids and radiotherapy to the whole brain with an intended dose of 5000 rads. Of the 41 patients who received some radiotherapy, 12 had a good response, and 13 a fair response. The median survival of all 45 patients with clinical evidence of metastases was 94 days, while the median survival of patients receiving at least 4000 rads cranial irradiation was 130 days from the onset of metastases. Brain metastases were the cause of death in 20 of the 45 patients whose metastases were diagnosed pre-mortem. The poor results of treatment of brain metastases which have become clinically apparent suggest that a controlled trial of elective brain irradiation in high-risk patients may be indicated.