Asymptomatic brain metastases (BM) in small cell lung cancer (SCLC) : MR-imaging is useful at initial diagnosis

• Published in: Journal of neuro-oncology Vol. 48; no. 3; pp. 243 - 248
• Main Authors: HOCHSTENBAG, M. M. H, TWIJNSTRA, A, WILMINK, J. T, WOUTERS, E. F. M, TEN VELDE, G. P. M
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01-07-2000; Springer Nature B.V
• Subjects: Antineoplastic Combined Chemotherapy Protocols; Biological and medical sciences; Brain Neoplasms - diagnosis; Brain Neoplasms - drug therapy; Brain Neoplasms - mortality; Brain Neoplasms - secondary; Carcinoma, Small Cell - diagnosis; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - mortality; Carcinoma, Small Cell - secondary; Combined Modality Therapy; Cyclophosphamide - administration & dosage; Disease-Free Survival; Doxorubicin - administration & dosage; Etoposide - administration & dosage; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Magnetic Resonance Imaging; Medical sciences; Pneumology; Radiography; Reproducibility of Results; Retrospective Studies; Survival Analysis; Time Factors; Tumors of the respiratory system and mediastinum; Performance evaluation; Human; Lung disease; Intracranial; Nervous system diseases; Respiratory disease; Asymptomatic; Malignant tumor; Metastasis; Nuclear magnetic resonance imaging; Bronchopulmonary; Cerebral disorder; Central nervous system disease; Bronchus disease; Medical imagery; Diagnosis; Small cell carcinoma
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1023/a:1006427407281

In this study we evaluated the usefulness of MR-imaging in the detection of asymptomatic brain metastases (BM) at the initial diagnosis in patients with small cell lung cancer (SCLC) and studied the follow-up of these patients.
One-hundred and twenty-five patients with SCLC were investigated with MR-imaging.
In 112 patients with normal neurological findings, MR-imaging of the brain demonstrated BM in 17 patients (15%). Six of these 17 patients were therefore upgraded to extensive disease (ED). Two of these 17 patients died during chemotherapy because of progressive disease and 3 patients became neurologic symptomatic with progressive disease on MR-imaging of the brain. After completion of chemotherapy a repeated MR-imaging of the brain in the remaining 12 patients showed 1 complete remission, 4 partial remission and 7 progressive disease of the BM.
This study showed that at presentation an unexpectedly high percentage of SCLC patients had asymptomatic BM on MR-imaging. We propose that MR-imaging of the brain should be included in the staging of SCLC patients as well for staging, prognosis and therapy.