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/m(2)/day 1 every 4 weeks) associated with etoposide (120 mg/m(2) days 1-3 every 4 weeks). 21 patients 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 progessive 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.