Abstract
Introduction Whilst recurrence is a well recognised phenomenon, the optimal protocol for surveillance after surgical treatment of non-small cell lung cancer (NSCLC) remains unclear. Early identification of intracerebral disease can improve morbidity and mortality (Linskey ME et al. J Neurooncol 2010; 96:45-68). In February 2015 CT head was added to routine CT chest/abdomen at 3, 12 and 24 months after surgery for all resected NSCLC patients at our trust.
Methods We prospectively reviewed all CT scans from February 2015 for patients undergoing radical surgery for NSCLC. We report data to January 2016.
Results 61 patients were identified. All patients had a baseline CT head prior to surgery showing no evidence of metastasis. There were 3 cases (5%) of intracerebral recurrence identified on CT surveillance. 2 patients were asymptomatic with intracerebral metastases amenable to stereotactic ablative radiotherapy (SABR). 1 patient was symptomatic and unfit for further treatment. 2 patients had R0 disease. Financial cost of adding CT head is minimal. There is only marginal increase in radiation dose (extra 1.8mSv).
Conclusion The introduction of CT head as part of surveillance of radically treatment non-small cell lung cancer patients has led to early identification of intracerebral recurrence amenable to treatment with SABR. The availability of SABR has led to longer patient survival in patients with solid brain metastases.
- Copyright ©the authors 2016
