Response of Brain Metastases from Lung Cancer to Systemic Chemotherapy with Carboplatin and Etoposide

30 consecutive patients suffering from cerebral metastases from lung cancer 12 small cell lung cancer (SCLC), 18 non-small cell lung cancer (NSCLC) were given systemic chemotherapy with carboplatin (300 mg/m2/day 1 every 4 weeks) associated with etoposide (120 mg/m2 days 1-3 every 4 weeks). 21 patient were untreated; 9 patients had had previous chemotherapy, 8 with platinum derivatives. Altogether 98 cycles of chemotherapy were administered. The results were as follows: 3 complete response (3 SCLC; 10%), 7 partial response (4 SCLC, 3 NSCLC; 23.3%), 5 stable disease (1 SCLC, 4 NSCLC; 16.7%), 15 progressive disease (4 SCLC, 11 NSCLC; 50%). The overall response was 33.3%. Of the 10 patients who responded to treatment, 4 had had previous chemotherapy with platinum derivatives. Treatment was generally well tolerated; 5 patients experienced grade 4 bone marrow toxicity; in 4 treatment was suspended because of progression, and 1 patient died after the 4th cycle due to pneumonia with bone marrow aplasia. Mean survival of patients responsive to treatment was 38.6 weeks (range 15-99); overall survival was 24.8 weeks (range 2-99), in SCLC 23 weeks (range 6-52) and in NSCLC 29.8 weeks (range 2-99). The combination of carboplatin and etoposide is highly successful in the treatment of cerebral metastases from lung cancer and it could be a valid alternative to the traditional radiotherapy.