This data might well suggest more aggressive treatment for patients since it appears the more extensively treated patients did better. It was in distant metastases as the first site of failure. This means the cancer travels beyond the local-regional areas. There was a slight increased rate of distant metastases as the first site in those patients who had supraclavicular lymph node positive versus not positive. There was no difference in the development of brain metastases based on supraclavicular lymph nodes.
Brain metastases are tumor cells that have traveled through the blood stream to enter the brain.
It is usually best diagnosed by MRI scanning using contrast. Brain metastases did occur more commonly in non-squamous cancers compared to squamous cancers. Treatment of brain metastases centers around radiation although in select cases surgery is used to decrease the pressure on the brain or debulk a large mass quickly. Currently randomized studies comparing chemotherapy radiation versus chemotherapy alone for unresectable Stage III lung cancer showed dramatically improved three year survival rates when chemotherapy and radiation are given. This data is the basis for administering both chemotherapy and radiation for locally advanced cancer.