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Cerebral metastases as first symptom of bronchogenic carcinoma. A prospective study of 37 cases
Author(s) -
Trillet Véronique,
Catajar JeanFrançois,
Cordier JeanFrançois,
Mornex JeanFrançois,
Brune Jean,
Croisile Bernard,
Aimard Gilbert,
Bourrat Charles,
Confavreux Christian,
Trouillas Paul,
Loire Robert,
Trillet Marc,
Tommasi Michel,
Turjman Francis,
Duquesnel Jean,
Bret Philippe,
Fischer Georges,
Deruty Robert,
Perrin Gilles,
Sindou Marc,
Goutelle Alain,
Lapras Claude,
Carrie Christian,
Chassard JeanLouis,
Chauvin Franck,
Gamondes JeanPaul,
Gerard JeanPierre
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910601)67:11<2935::aid-cncr2820671138>3.0.co;2-#
Subject(s) - medicine , radiation therapy , lung cancer , chemotherapy , lung , carcinoma , primary tumor , large cell , surgery , cancer , radiology , small cell carcinoma , chest radiograph , metastasis , radiography , adenocarcinoma , oncology
Among the patients showing evidence of cerebral metastases without previously known cancer history, lung cancer has been found 37 times as the primary tumor in our institution. There were 34 men and three women and all but two were heavy smokers. Only one presented at diagnosis with thoracic symptoms but the chest radiograph was abnormal in 34. The histologic type of the primary tumor was obtained in 32 cases as a result of thoracic investigations and in five cases from metastatic tumor tissue. The primary tumor appeared to be non‐small cell lung carcinoma in 26 cases and small cell lung carcinoma in 11 cases. These results show that patients treated with surgery (20 cases) have a better survival (median 10 months versus 4.5) than the others, and among surgically treated patients only those treated with bifocal resection (eight patients) are long‐term survivors. Also, in four of six patients, objective regression of the neurologic symptoms was seen after radiation therapy alone. Central nervous system relapse was seen in 12 patients, but in none of the patients treated with postoperative radiation therapy. Conventional chemotherapy (11 patients) induced objective responses only in the small cell type and proved to be too toxic when used simultaneously with radiation therapy in inoperable patients.