Showing papers by "Fred R. Hirsch published in 1979"

Development of Brain Metastases in Small-Cell Anaplastic Carcinoma of the Lung

Abstract: Small-cell anaplastic carcinoma (sm.a.c.) of the lung, unlike other types of lung cancer, is known to disseminate very early and widely. Evidence for this comes from staging procedures, such as mediastinoscopy, bone marrow examination and peritoneoscopy with liver biopsy (Selawry and Hansen, 1973). The brain is also a frequent site for distant metastases in sm.a.c. with an incidence of approximately 10 per cent at the time of diagnosis (Newman and Hansen, 1974; Reed and Livingston, 1977) and 29 to 50 per cent at autopsy (Line and Deeley, 1971; Takita et al., 1973; Eagan et al., 1974; Auerbach et al., 1975). Within the last five years considerable progress has been made in the treatment of this disease by the use of combination chemotherapy resulting in a significant prolongation of life (Hansen, 1977). During this period brain metastases have emerged as a specific therapeutic problem, presumably because some of the most active compounds against this disease cross the blood-brain barrier poorly, thereby leaving the brain as an unprotected reservoir for metastatic seeding. Accordingly, detailed information on the development of brain metastases in patients with sm.a.c. is important.