Prognostic factors were examined in 38 patients with nonsmall cell lung carcinoma and brain metastases. The most important factors were the response to total therapy (corticosteroids, radiotherapy, and chemotherapy) and the presence of brain metastases alone; these factors had the most impact on survival. Age, sex, histologic type of lung cancer, and initial performance status were not prognostically important. Our results indicate that certain subgroups of patients with nonsmall cell lung carcinoma and brain metastases have a favorable prognosis and should be treated aggressively.