Table 1.

Current Treatment Modalities for Lung Cancer Brain Metastasis.

Clinical Presentation	Modalities	Efficacy	Reference
Solitary Lesion	Surgery	Dependent on aggressiveness of tumor; generally effective with solitary lesions	Reviewed in Lippitz et al. (2014)
Solitary Lesion	Whole Brain Irradiation; Stereotactic Radiosurgery	Most effective against single lesions. Stereotactic radiosurgery associated with less morbidity. Combination stereotactic radiosurgery and whole brain irradiation may further improve survival.	Wegner et al. (2011)
Multifocal Lesion	Whole Brain Irradiation	Generally less effective; multiple lesions indicative of more advanced disease. Can be palliative. Often used in combination with stereotactic radiosurgery or local surgical resection.	Khan and Dicker (2013); Soffietti et al. (2013)
Multifocal Lesion	Stereotactic Radiosurgery	May be indicated if lesions are well-defined; generally palliative. Combination with whole brain irradiation may provide additional benefit.	Wegner et al. (2011)
Multifocal Lesion	Systemic chemotherapy	Difficulty with many cytotoxic chemotherapeutics in crossing the blood brain barrier. Targeted small molecules, such as anti-EGFR drugs may be effective in some instances. Eventual tumor regrowth as resistance to therapy develops.	Fan et al. (2014)
EGFR or ALK Mutant NSCLC (Confirmed)	Targeted therapy with small molecule TKIs/ALK inhibitor	Highly effective in shrinking brain metastasis bearing mutations matching the primary tumor; evolution of resistance remains a clinical problem as in primary-site disease.	Jamal-Hanjani and Spicer (2012); Costa et al. (2015)