Gefinitib is an inhibitor of the epidermal growth factor receptor that induces an early and dramatic response in locally advanced or metastatic non small cell lung cancer. There are some report that gefinitib is effective for btain metastasis of the non small cell lung carcinoma, but the response Gefinitib and Gamma Knife surgery have not been described. 

     We report 3 cases with brain metastasis from lung adeocarcinoma who rapidly decrease tumor size and inproved neurological symptoms after two fractionated gamma knife treatment and gefinitib.

     The mean age of the patients was 69.7 years old(range :49-85 ),1 men and 2 women.

     From June 2010 to April 2011, 3 patients with brain metastasis treated with gefinitib and gamma knife, firstly presented neulogical symptoms before diagnosed lung adenocarcinoma. Mean follow up period was 10 month(range:7-14) The mean tumor size was 16.5ml(range:2.8?44.3). Gamma knife treatment protocall was 26-28Gy/2 fr / 4week. All patient started to taking Gefinitib after first gamma knife treatment.

     All patients dramatically reduced their tumor volumes after taking Gefinitib and first gamma knife treatment . Mean tumor size was 3.27ml(range 0.882-7.6ml) at the second gamma knife treatment. All of the tumors was controlled,and none of them recurrd in the follow up period.

     This was a small retrospective series.

     We report 3 cases of metastatic brain tumor who dramatically respond to gefinitib and Gamma knife treatment. Combine Gamma knife treatment and gefinitib effect synergistically in some patients of metastatic lung carcinoma. 

     It will be important to investigate the synergistic effect of combined gefinitib and gamma knife radiosurgery for lung cancer brain tumors.