Abstract
Background: Danish guidelines have since February 2014 recommended MR of the brain prior to curative radiotherapy in patients with NSCLC and N2-disease. More recently O'Dowd et al. [Lung Cancer 86 (2014) 185–189] have suggested MR of the brain prior to surgery no matter the stage.
Aim: To study whether the introduction in 2010 of follow-up by CT of thorax and upper abdomen every three months has reduced the incidence of relapse suspected from CNS-symptoms.
Results: All 827 NSCLC patients from Funen completing curative treatment from 2005 to 2013 were included. The total number of relapses found after symptoms within 24 months decreased in the 3½ years after the introduction of CT-based follow-up, p < 0,001 (table), but the total fraction presenting with CNS-symptoms did not change, p = 0.296. Relapses after stage I cancer decreased (p = 0.025), while no differences or changes for stages II or III were found.
Conclusion: CT-based follow-up has not reduced the incidence of relapse suspected from CNS-symptoms in stage II-IV, and therefore we suggest routine MR of the brain before curative treatment for this group of patients.
| Number, fractions(%), and [95%CI] | Jan. 2005 - June 2010 | July 2010 - Dec. 2013 |
| Patients with intended curative treatment | 449 | 378 |
| Relapse within 24 months | 172 (38.3%) [33.8-43.0%] | 155 (41.0%) [36.0-46.2%] |
| Relapse suspected from symptoms | 118 (26.3%) [22.3-30.6%] | 49 (13.0%) [9.8-16.8%] |
| Relapse suspected from CNS-symptoms | 30 (6.7%) [4.6-9.4%] | 18 (4.8%) [2.9-7.4%] |
| - Stage I | 9 (4.1%) [1.9-7.7%] | 1 (0.6%) [0.0-3.0%] |
| - Stage II | 7 (7.0%) [2.9-13.9%] | 6 (6.7%) [2.5-14.1%] |
| - Stage III | 13 (10.7%) [5.8-17.5%] | 8 (9.0%) [4.0-17.0%] |
| - Stage IV - with initial brain metastases | 1 (16.7%) [4.2-64.1%] | 3 (50.0%) [11.8-88.2%] |
- Copyright ©the authors 2016
