Long-term survival following gamma knife surgeries for recurrent multiple brain metastases of pN2-non-small cell lung cancer

Background. By stereotactic radiosurgery or surgical treatment of brain metastases and resection of the primary tumor in non-small cell lung cancer, the patient outcome can be improved in pNO but can hardly be improved in pN1-2. Case. A 45-year-old woman was referred to our hospital because of a 3 x 3-cm nodule in the upper lobe of the left lung on a chest radiograph. Chest CT revealed a 3 x 3-cm nodule in the upper lobe of the left lung and a swollen #5 lymph node. The nodule was found to be adenocarcinoma by brushing cytology via bronchofiberscopy. Cranial MRI revealed brain metastasis. She underwent a left upper lobectomy. Histologic examination revealed papillary adenocarcinoma and metastases to # 5 and # 12u lymph nodes. Three weeks after thoracotomy, she underwent gamma knife surgery of the brain metastasis. Five months and 8 months after thoracotomy, she underwent gamma knife surgeries of recurrent multiple brain metastases. She received 2 courses of chemotherapy consisting of cisplatin and gemcitabine. Fifteen months and 41 months after thoracotomy, she underwent gamma knife surgeries of recurrent multiple brain metastases. She is now apparently disease-free from lung cancer, 76 months after thoracotomy.