Brain Radiotherapy Combined with Sequential Chemotherapy in Non-Small-Cell Lung Cancer Patients with Brain Metastases

BACKGROUND:Brain irradiation is the traditional treatment for NSCLC patients with brain metastases, whereas combined with chemotherapy is the nowadays treatment direction. Since sequential/maintenance chemotherapy has shown promising results in advanced NSCLC, we carried out the study to explore the role of sequential chemotherapy combined with brain radiotherapy in patients with brain metastases.METHODS:Treatment naive NSCLC patients with brain metastases sequentially received the 3 chemotherapy regimens TP-NP-GP. The TP regimen consisted of Paclitaxol 175 mg/m(2) d1, Cisplatin 20 mg/m(2) d1-5. The NP regimen consisted of Nevalbine 25 mg/m(2) d1 and 8, Cisplatin 20 mg/m(2) d1-5. The GP regimen consisted of Gemcitabine 1 g/m(2) d1 and 8, Cisplatin 20 mg/m(2) d1-5. All regimens were repeated every 3 weeks. Each regimen was executed for at least 2 cycles and no more than 4 cycles.RESULTS:The response rates of TP, NP and GP sequentially used were 41.2%, 35.6% and 27.8% respectively for the out brain lesions and 60.8% for the brain lesions combining with brain irradiation. Median survival time was 14.7 months and the 1, 2 and 3 year overall survivals were 67.8%, 20.6% and 1.3% respectively.CONCLUSIONS:The 3rd generation regimen-based sequential chemotherapy combined with WBRT was effective for NSCLC patients with brain metastasis with an encouraging survival and acceptable tolerability.