抄録
This paper studied the biological nature of brain metastasis of lung cancer correlated with their histological types and CT findings, and investigated the prognostic factors in treating these cases. Fortytwo cases were treated since 1977. The histological types were: 17 cases of adenocarcinoma; 9 of squamous cell cancer; 7 of small cell; 6 of large cell; and 3 of unclassified lung cancer.
The overall incidence of single metastatic lesions were more frequent than multiple lesions (23: 19). However, multiple lesions were common in squamous cell and large cell cancers, while single lesions were more common in adenocarcinoma and small cell cancer at their early stages. Rather characteristic CT findings were found for each histological type; when such parameters were taken into consideration e.g., size, shape, multiplicity mode of enhancement in the metastatic lesion, and the grade of peritumoral edema and brain shift. The 39 surgical cases were treated with irradiation and/or systemic chemotherapy. Overall mean survival time was 6 months after treatment and the 1 and 2 year survival rates were 20.5% and 7.6%, respectively. Mean survival time was 16.3 months in cases with total removal of metastasis followed by whole brain irradiation, and was 20.5 months in cases treated with total removal, postoperative irradiation, plus scheduled chemotherapy (ACNU and FT-207). From analysis of the 8 longest surviving cases, the most favorable outcome was for cases of adenocarcinoma with single brain metastasis, in cases receiving multidisciplinary therapies, and when the primary lesions were controlled. In conclusion, early diagnosis by CT scan and specified, multidisciplinary treatments based on the histological type are advised for a more favorable prognosis for cases of metastatic brain tumor arising from lung cancer.
