Concomitant Treatment for Brain Metastases in Non-Small Cell Lung Cancer Patients: Our Clinical Experience

• S. Simonida Crvenkova

  University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Skopje, FYRO Macedonia

• Maja Popova

  University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Skopje, FYRO Macedonia

Purpose: Aim of this study was to evaluate tumor response, Quality of life (QoL) and median survival of concomitant chemotherapy (P/E) protocol with WBRT (whole brain radiotherapy) followed by P/E protocol until progression or appearance of serious adverse effects in NSCLC patients with multiple brain metastases. Methods: From December 2012 to April 2014, 12 patients were enrolled in this study. All of the patients received previous treatments. Selected patients had multiple brain metastases detected on CT and/or MRI, and the brain is only one site of disease dissemination and patients were at younger age. External beam radiotherapy was administered with two lateral opposed fields. Concurrently with WBRT, patients received P/E protocol and after 4 weeks, followed by P/E protocol repeated on 21 days until progression or appearance of serious adverse effects. Tumor response was assessed according to RECIST criteria. Assessment of QoL was performed by patients’ subjective answers, subjective improvement in emesis, ataxia, headache and seizures and without subjective improvement. Adverse effects were performed according to WHO criteria. Overall survival was analyzed from the beginning of the concomitant treatment until death or patient’s last control. Results: Common adverse events were neurotoxicity and hematology toxicity according to WHO criteria. No patient was withdrawn from the study because of the adverse events. All patients reported subjective improvements. Overall median survival was 7.5 months (95% CI 6.32-8.73). Conclusions: WBRT plus chemotherapy can improve the efficacy and QoL in NSCLC patients, because of synergistic effect and current evidence that the blood-brain barrier is damaged in patients with BM. Considering our clinical results, we recommend this treatment as safe and effective for selected NSCLC patients.

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