Brain metastasis in the natural history of small-cell lung cancer: 1972-1979.

The records of 134 patients with small-cell lung cancer who had been seen at Henry Ford Hospital between 1972-1979 were reviewed with emphasis on brain metastasis. Brain metastasis developed in 28% of the patients; 21% had brain metastasis at the time of diagnosis and in 7% it developed later (de novo). In 9%, the chief complaint was related to brain metastasis. Brain metastasis in only two of 109 patients developed after diagnosis (de novo) yet prior to initiation of prophylactic brain radiation. The frequency of de novo brain metastasis in those treated with intensive combination chemotherapy and those treated by other means was similar. Of the patients with brain metastasis, 73% died from other causes. Isolated brain metastasis in the absence of progressive systemic disease was rare.