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- Title
Radiation-Refractory Brain Metastases in Patients with Non-Small Cell Lung Cancer.
- Authors
Spiceland, Clayton M.; Olivier, Kenneth R.; Jatoi, Aminah
- Abstract
Background: Numerous studies have focused on the treatment of non-small cell lung cancer patients with brain metastases. However, to our knowledge, few have sought to examine outcomes in patients who required whole brain radiation and developed radiation-refractory disease. Methods: This study examined the medical records of all non-small cell lung cancer patients who developed brain metastases between 2004 and 2013, required whole brain radiation, and received their cancer treatment at the Mayo Clinic in Rochester, Minnesota. Results: A total of 141 patients, most of whom were symptomatic, met the above criteria. Of these, 33 (23%) did not tolerate a corticosteroid taper and were therefore deemed to have radiation-refractory disease. The median survival of patients with and without radiation-refractory disease was 3.12 and 4.27 months, respectively, (hazard ratio [HR]: 0.65 [95% confidence interval (CI): 0.44-0.99]; p=0.04 by log rank test). In a subgroup analysis of patients with radiation-refractory disease ( n=33) and radio-responsive disease ( n=43), median survival was 3.12 and 5.94 months, respectively (HR: 0.43 [95% CI: 0.26-0.70]). Among patients with radiation-refractory disease, 12 received chemotherapy after radiation, and two received erlotinib. Systemic therapy was associated with improved symptoms in two patients but did not appear to improve survival. Conclusion: Non-small cell lung cancer patients with radiation-refractory brain metastases represent a small subgroup who have a short survival and who appear to derive minimal benefit from systemic cancer therapy.
- Subjects
MINNESOTA; ADRENOCORTICAL hormones; HORMONE therapy; BRAIN tumor treatment; LUNG cancer complications; CANCER treatment; ERLOTINIB; BRAIN tumors; CANCER chemotherapy; CONFIDENCE intervals; METASTASIS; SURVIVAL analysis (Biometry); SURVIVAL; DESCRIPTIVE statistics; THERAPEUTICS
- Publication
Journal of Palliative Medicine, 2015, Vol 18, Issue 8, p707
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2015.0097