Clinical evaluation of brain metastases from lung cancer.

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Among 649 patients with lung cancer during the past 10 years, 57 (8.8%) were proved to have brain metastases. From a histological standpoint, brain matastases were most prevalent in large cell carcinoma, followed by small cell carcinoma, adenocarcinoma and squamous cell carcinoma, in decreasing frequency. The initial symptoms and signs varied, and included headache, neurologic defects and so on. The interval between the diagnosis of lung cancer and the appearance of brain metastases was longer in adenocarcinoma than in other histologic types. The manifestation of brain metastases before the diagnosis of lung cancer was established was noted with greater frequency in adenocarcinoma than in other hisologic types. Solitary and multiple brain metastases were shown by brain CT to occur in equal numbers. Furthermore, characteristics most commonly seen in adenocarcinoma by brain CT were as follows: 1) Solitary lesion, 2) Isodensity on plain CT, 3) Location in frontal lobe, 4) Solid in form, 5) Severe edema surrounding the metastatic tumor. With regard to the management of brain metastases, most patients were treated with combined radiation-chemotherapy. Nevertheless, thoracotomy in conjunction with craniotomy was likely to give the most benefit in terms of survival prolongation. Autopsy studies confirmed metastases as the cause of death in more than half of patients with brain metastases.
特定非営利活動法人日本肺癌学会の論文