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Chemotherapy for NSCLC usually includes combination of two drugs (chemotherapy doublet), with one of the agents is cisplatin or carboplatin. In 2002, Schiller at al. published in the New England Journal of Medicine, a study that compared four chemotherapy regimens for advanced NSCLC, cisplatin and paclitaxel, cisplatin and gemcitabine, cisplatin and docetaxel, and carboplatin and paclitaxel. [14]
A theory was developed that the brain was likely a pharmacologic sanctuary where sub-clinical metastases were protected from cytotoxic drugs by the blood–brain barrier. Oncologists hypothesized that treatment of this sub-clinical disease with radiation therapy may stamp out the malignant process before it could advance to cause symptoms.
Lung and breast cancers account for over half of brain metastases. [11] The most common sources of brain metastases in a case series of 2,700 patients undergoing treatment at the Memorial Sloan–Kettering Cancer Center were: [12] Lung cancer, 48%; Breast cancer, 15%; Genitourinary tract cancers, 11%; Osteosarcoma, 10%; Melanoma, 9%; Head and ...
Adenocarcinoma of the lung is currently the most common type of lung cancer in "never smokers" (lifelong nonsmokers). [10] Adenocarcinomas account for about 40% of lung cancers. Historically, adenocarcinoma was more often seen peripherally in the lungs than SCLC and squamous-cell lung cancer, both of which tended to be more often centrally located.
Lung cancer most commonly metastasizes to the brain, bones, liver, and adrenal glands. [14] Lung cancer can often appear as a solitary pulmonary nodule on a chest radiograph or CT scan. In lung cancer screening studies as many as 30% of those screened have a lung nodule, the majority of which turn out to be benign. [15]
Clinically, research evidence demonstrated that the primary tumours that have the greatest association with brain metastasis consist of lung, breast, melanoma, and colon cancers. [ 1 ] [ 5 ] Despite the knowledge of sources, there is a lack of understanding regarding why these sources have increased predilection , nor an understanding of the ...
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