Brain scans are frequently obtained in lung cancer patients with central nervous system (CNS) symptomatology to confirm brain metastases, and in those without CNS symptoms for the detection of occult metastases so that appropriate therapy may be instituted promptly. This study was undertaken to evaluate the impact of brain scanning on survival in patients with inoperable lung cancer. Of 184 consecutive cases of advanced lung cancer reviewed retrospectively, 110 had brain scans performed. Positive brain scans were obtained in 17 of 26 symptomatic patients but in only 4 of 84 asymptomatic patients. The presence of brain metastases did not shorten survival in symptomatic or asymptomatic patients subsequently receiving cranial irradiation. While preoperative brain scanning may prevent unnecessary extensive operation, routine postoperative brain scanning asymptomatic lung cancer patients can be expected to have a low yield. Brain scanning in symptomatic patients is a reliable and sensitive method for confirming brain metastases.
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