Long-term survival following concurrent chemoradiotherapy in patients with non-small-cell lung cancer with concomitant brain metastases only

We report two patients with non-small-cell lung cancer (NSCLC) with concomitant metastases to the brain only who received chemotherapy with concurrent radiotherapy for the thoracic disease and brain disease, resulting in long-term survival. One patient was a 56-year-old woman who was diagnosed as having adenocarcinoma and showed T2N1 thoracic disease; the other patient was a 57-year-old man diagnosed with squamous cell carcinoma who had T1N3 thoracic disease. Both patients demonstrated multiple metastases to the brain only. Chemotherapy, consisting of cisplatin (40mg/m2) and docetaxel (40mg/m2), was administered on days 1 and 8, with the drugs being given separately, and the chemotherapy was repeated every 4 weeks for up to three cycles. Whole-brain irradiation (2Gy/day; total, 36Gy) and thoracic irradiation (2Gy/day; total, 60Gy) were started on days 1 and 29, respectively. Toxicities encountered were manageable by conventional therapy. The concurrent chemoradiation therapy resulted in complete regression of the brain disease in both patients. Brain disease relapsed in the female patient, but it is being controlled by the administration of gefitinib. She has survived for 53 months since the start of treatment, without new metastatic lesions or relapse of the thoracic lesions. The male patient has survived for 37 months without new metastatic lesions or relapses. Concurrent chemoradiotherapy in which radiotherapy is applied to both the brain and thoracic lesions may be effective for patients with NSCLC with metastases to the brain only. © The Japan Society of Clinical Oncology 2005.