Gefitinib Alone or with Whole Brain Radiotherapy for Patients with Brain Metastasis from NSCLC

Brain metastases (BM) are found in approximately 20-40% of all patients with non-small-cell lung cancer (NSCLC), especially in adenocarcinoma (Olak 1999; Yawn et al., 2003). The outcomes of BM from NSCLC are very poor with few effective treatment options. The median overall survival time (OS) of patients without treatment is less than 3 months (Nussbaum et al., 1996). Whole brain radiotherapy (WBRT) as a standard therapy for patients with BM from NSCLC had been commonly used with median OS ranging from 3 to 6 months. Chemotherapy leads to a median survival of 3-6 months for patients with BM from NSCLC. Few pilot studies reported that patients with BM from NSCLC treated with chemotherapy concurrently with WBRT had a median OS of 7.6-8 months (Furuse et al., 1997; Quantin et al., 1999; Moscetti et al., 2007). Gefitinib, a tyrosine kinase inhibitor (TKI) of epidermal growth factor receptor (EGFR), was reported to