Study Finds Better Survival in Lung Cancer with Brain Metastasis

Norwegian researchers found that lung cancer patients with brain metastasis who got aggressive treatment for the brain lesions did better overall than patients with stage IV lung cancer.

Patients who have lung cancer with brain metastasis (BM), and who receive aggressive treatment for the BM have a better overall survival rate than patients with stage IV lung cancer, according to a study conducted by Peter Hatlen, PhD, MD, Department of Thoracic Medicine, St. Olav's Hospital, HF, in Trondheim, Norway, and colleagues. The study was published in the Journal of Pulmonary & Respiratory Medicine.

The researchers undertook this study to find out whether microsurgery or gamma knife surgery (GKS) was more effective, and what factors affect the survival rate in patients with lung cancer and brain metastasis. Study participants included all patients coded for lung cancer and brain metastasis according to the International Classification of Diseases (ICD) 10 between January 2006 and December 2014 at the Trondheim University Hospital. The control population was drawn from the “survival data for lung cancer patients in stage IV from the middle region of Norway.”

Several study variables were recorded: sex, age at the time of lung cancer diagnosis, T and N stage, number of brain metastasis, the diameter of the largest BM, and whether or not the patient had received microsurgery or GKS to treat the BM. Researchers considered the 1-year, 2-year, and 3-year survival rates. After exclusions, 42 patients were included in the researchers’ analyses.

The statistical analysis of the data revealed three important pieces of information, they wrote. First, the survival rate of patients in the study with lung cancer and BM was higher than that of the control population, which had stage IV lung cancer. Second, patients who were treated with microsurgery had a higher survival rate than those who received GKS. And, finally, patients who had BM at the time of diagnosis had a lower survival rate than those who developed BM later in the course of the disease.

The researchers caution that they had no information regarding the quality of life, which is an important factor when determining the course of treatment. The study population was also small, included patients from only one center, and was retrospective in design, all of which are limitations for interpreting the results. Further studies, particularly prospective studies, are needed.