for these patients. They are generally treated by simple palliative techniques; whole brain XRT and chemotherapy with or withoutchest XRT. Considering the possibility of less advanced disease and better performance status of this group of NSCLC patientscompared to those who develop brain metastases after their initial diagnosis, we performed a retrospective study to determinewhether aggressive treatments to brain, lung or both is beneficial in disease control and/or survival.Materials/Methods:The cases of 75 patients presenting with non-small cell lung carcinoma with synchronous brain metastasestreated between 1998-2002 were reviewed at Upstate Medical University at Syracuse. Patients were assessed for aggressive treat-ment to the brain with either craniotomy or gamma knife radiosurgery and aggressive treatment to the primary lung cancer withsurgery, chemoradiation therapy or both.Results:Median follow-up was 15 months. 43 patients received aggressive treatment to brain, 20 received aggressive treatment tolung and 45 patients had palliative treatment. 21 patients recurred in the brain, (10/43 in aggressive treatment group, 11/36 palli-ative group). 9 patients recurred or demonstrated progressive disease in the lung (1/12 aggressive treatment group, 8/63 in non-aggressive group). The median survival was 7.9 months for the entire cohort, 8.4 months in the aggressive treatment group and7.7 months in the non-aggressive treatment group (p= 0.44). There were 10 long-term survivors living more than 2 years. 2 of
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lung carcinoma, aggressive treatment, aggressive treatment group