Efficacy of surgical treatment for brain metastasis in patients with non-small cell lung cancer.
PURPOSE
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.


MATERIALS AND METHODS
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.


RESULTS
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).


CONCLUSION
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.
['Kim|Sang Young|SY|', 'Hong|Chang Ki|CK|', 'Kim|Tae Hoon|TH|', 'Hong|Je Beom|JB|', 'Park|Chul Hwan|CH|', 'Chang|Yoon Soo|YS|', 'Kim|Hyung Jung|HJ|', 'Ahn|Chul Min|CM|', 'Byun|Min Kwang|MK|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001932:Brain Neoplasms D002289:Carcinoma, Non-Small-Cell Lung D003710:Demography D018572:Disease-Free Survival D005260:Female D005500:Follow-Up Studies D006801:Humans D053208:Kaplan-Meier Estimate D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D016896:Treatment Outcome
brain metastasis Non-small cell lung cancer quality of life neurosurgery treatment outcome