Background & Objective: The main treatment strategy of cancer patients with brain metastases was irradiation; while so far there were few researches concerning chemotherapy combined with radiotherapy for these patients. This study was designed to observe the therapeutic effect, toxicity, and survival of concurrent whole-brain radiotherapy (WBRT) combined chemotherapy with COAPC regimen in non-small cell lung cancer (NSCLC) patients with brain metastases.
Methods: A total of 45 NSCLC patients with brain metastasis received a course of COAPC regimen [cyclophosphamide 0.3 mg/m(2) i.v. d(1), vincristine 1.4 mg/m(2) i.v. d(1), doxorubicin 50 mg/m(2) i.v. d(1), cisplatin 20 mg/m(2) i.v. d(1-5), semustine 80 mg/m(2) PO d(1)] every 3-4 weeks. Whole-brain radiotherapy was administered on day 6 of the first course of chemotherapy using (60)Co at a dose of 2 Gy given in 5 fractions per week. Patients with brain lesions of 1-3 received WBRT at a dose of 40 Gy and then small field to a total dose of 60 Gy. Patients with brain lesions of more than 3 received WBRT at a total dose of 40 Gy.
Results: The treatment improved neurological symptoms in 80% of the patients. The response rates to brain lesions and primary lesions were 64.4% and 40.0%, respectively. The median survival time (MST) was 10 months. The 1-year and 5-year survival rates were 44.1% and 6.7%, respectively. The MST in the patients with brain metastasis was only 14 months,which was longer than the MST of 9 months in the patients with other metastasis sites(P=0.012).
Conclusion: Concurrent WBRT and chemotherapy can be safely preformed for the patients with brain metastasis from NSCLC with a remarkable response rate and encouraging survival duration.
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