Ueoka H
Second Dept. of Medicine, Okayama University Medical School.
Gan To Kagaku Ryoho. 1997 Oct;24 Suppl 3:426-31.
Treatment for brain metastases of lung cancer was reviewed. For single brain metastasis of non-small cell lung cancer, surgical resection followed by whole brain irradiation (WBI) or stereotactic radiosurgery (SRS) showed a better treatment outcome compared with WBI alone. A randomized trial comparing surgical resection plus WBI with SRS may be warranted. For multiple brain metastasis, WBI is now the sole effective therapy. However, an optimal schedule of radiotherapy has not yet been established. For brain metastasis of small-cell lung cancer (SCLC), rapid improvement of symptoms is achieved with WBI, while the response duration is brief. Recently, the brain metastasis from SCLC is suggested to respond as well to the systemic chemotherapy as does extracranial disease, even though it has not been documented in randomized trials. Consolidating WBI after systemic chemotherapy for the brain metastasis from SCLC should be evaluated.
对肺癌脑转移的治疗进行了综述。对于非小细胞肺癌的单发性脑转移，与单纯全脑照射（WBI）相比，手术切除后再进行全脑照射（WBI）或立体定向放射外科治疗（SRS）显示出更好的治疗效果。可能有必要进行一项比较手术切除加WBI与SRS的随机试验。对于多发性脑转移，WBI目前是唯一有效的治疗方法。然而，尚未确定最佳的放疗方案。对于小细胞肺癌（SCLC）的脑转移，WBI可使症状迅速改善，但缓解期较短。最近，有研究表明，SCLC的脑转移对全身化疗的反应与颅外疾病相同，尽管在随机试验中尚未得到证实。对于SCLC脑转移，应评估全身化疗后巩固WBI的效果。
