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November 7, 1980

Brain Metastases in Small Cell Carcinoma

Author Affiliations

Eisenhower Army Medical Center Fort Gordon, Ga
Fitzsimons Army Medical Center Denver

JAMA. 1980;244(18):2048. doi:10.1001/jama.1980.03310180018021

To the Editor.—  We appreciated the comments by Okin and Brandstetter (243:2154, 1980) in respect to our study on small cell carcinoma of the lung (242:2084, 1979). They reviewed their data and obtained different results. We agree with their comment that the observed differences could be secondary to a different patient population. Only 24% of their patients had brain metastases develop. This is much lower than that which is reported in the literature, with some authors reporting an incidence as high as 65% in patients on whom autopsies were performed.1 If the incidence were truly 24%, then prophylactic cranial irradiation (PCI) would be difficult to justify in this tumor.In their letter they state that their longer mean survival of 5.75 months for those patients with brain metastases vs 3.5 months for those without brain metastases was not statistically significant. They commented that this was similar to our mean