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KMID : 0942820060050020077
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Journal of Korean Brain Tumor Society
2006 Volume.5 No. 2 p.77 ~ p.84
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Result of Adjuvant Therapy after Metastatectomy for Brain Metastasis from Non-small Cell Lung Cancer
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Kim Young-Zoon
Yoo Heon
Yang Hee-Seok
Shin Sang-Hoon
Lee Seung-Hoon
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Abstract
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Purpose: This study was aimed to compare the survival and recurrence according to postoperative adjuvant therapeutic modalities for brain metastasis.
Methods: From June 2002 to December 2005, 49 patients with brain metastasis from non-small cell lung cancer(NS CLC) underwent adjuvant systemic chemotherapy or whole brain radiotherapy(WBRT) or both after metastatectomy. In Group A, 13 patients were treated with systemic chemotherapy and WBRT after brain surgery. In Group B, 11 patients were treated with WBRT only after brain surgery and in Group C, 25 patients with systemic chemotherapy only after brain surgery.
Results: Median survival times were 12.7 months in Group A, 5.0 months in Group B, and 11.6 months in Group C. Median time to progression of local disease were 7.7 months in Group A, 4.0 months in Group B, and 4.4 months in Group C. There were no statistical differences in survivals and local recurrences according to postoperative adjuvant therapeutic modalities. Favor factor for the survival was RPA class I only. And favor factors for the local recurrence were metachronoous presentation, RPA class, extensive surgical resection, gender and Sawaya grade.
Conclusion: In this study, we suggest that postoperative systemic chemotherapy for brain metastasis after brain metastatectomy, instead of adjuvant WBRT, can control primary cancer and brain disease simultaneously and prevent neurocognitive dysfunction originating from WBRT.
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KEYWORD
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Brain metastasis, Adjuvant systemic chemotherapy, Whole brain radiotherapy, Non-small cell lung cancer
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