Lower risk of brain mets from screening. LDCT Screening linked to lower risk of brain mets for lung cancer patients.

Lower risk of brain mets for lung cancer patients could lead to longer survival. Patients with primary lung cancer detected with low-dose computed tomography (LDCT) screening have a lower risk of developing brain metastases than patients whose cancer was detected through other methods, researchers found.

After adjusting for age at diagnosis, cancer stage, histology, and smoking status, patients whose lung cancer was detected with LDCT screening had a significantly lower 3-year incidence of brain metastases (6.5%) compared with patients whose cancer was detected through chest x-ray screening, incidental detection, or clinical symptom-based detection (11.9%), with a cause-specific HR of 0.53 (P=0.001), reported Summer Han, PhD, of Stanford University School of Medicine in California, and colleagues in the Journal of Thoracic Oncology.

“LDCT screening for primary lung cancer may be beneficial for reducing brain metastases risk,” in addition to “early detection of primary lung cancer and lung cancer-specific mortality reduction as already shown in the National Lung Screening Trial,” Han told MedPage Today.

Lower risk of brain mets and lung cancer survival

Patients with lung cancer who are diagnosed with brain metastases have poor survival, with most surviving only 3 or 4 months after diagnosis, the researchers said. However, patients who have well-controlled or asymptomatic brain metastases have better survival, indicating the importance of early detection.

Han and colleagues used data from the large, prospective, population-based, randomized National Lung Screening Trial. The study included 1,502 patients diagnosed with primary lung cancer (median age 65.9 years at time of diagnosis) from 2002 to 2009 with follow-up data available on brain metastases.

Of these patients, 76.8% had early-stage primary lung cancer, 41.8% had adenocarcinoma, and 55% had undergone surgery as primary treatment. When broken down by mode of detection, 41.4% had their cancer detected by LDCT screening compared with 58.6% whose cancer was detected by other methods.

The 3-year cumulative incidence of brain metastases after a lung cancer diagnosis was 9.4% for the entire cohort.

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