[Paclitaxel and cisplatin combined with etoposide chemotherapy in non-small cell lung cancer with brain metastases].

BACKGROUND & OBJECTIVE: Chemotherapy has been rarely considered an important treatment modality for non-small cell lung cancer (NSCLC) with brain metastases (BM) because of the existence of blood-brain barrier (BBB). In the recent years,the studies about BBB suggest that many agents (such as paclitaxel, cisplatin) have increased permeability to BBB once BM occur. Therefore, we addressed the role of this combination with paclitaxel,etoposide, cisplatin (some effective agents to NSCLC) as front-line therapy in NSCLC with BM.

METHODS

20 chemotherapy-naive patients with documented BM from NSCLC and at least one evaluable extracerebral lesion were treated with paclitaxel (150 mg/m(2)) on day 1, etoposide (60 mg/m(2)) on day 1,3,5,and cisplatin (20 mg/m(2)) on day 1-5. The cycle was repeated every 28 days.

RESULT

17 patients were evaluated for response and 19 for toxicity. The intracranial objective response rate (ORR) was 41%,the extracranial ORR was 53%. Patients who responded for the brain also had a response at the extracerebral sites. Grade 3-4 myelosuppression occurred in 21% of the patients. The overall medican follow-up was 9 months. The medican survival time for the 9 died patients was 8.5 months.

CONCLUSIONS

Paclitaxel and cisplatin combined with etoposide as front-line therapy in NSCLC with BM has some efficacy. The toxicity is mild. This combination chemotherapy seems to achieve responses similar to those for extracranial diseases, and further support the need for reconsideration of the role of chemotherapy in this setting.