Department of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Strahlenther Onkol. 2014 Jan;190(1):64-7. doi: 10.1007/s00066-013-0439-6. Epub 2013 Oct 9.
This study investigated the potential prognostic value of the number of involved extracranial organs in patients with brain metastasis from non-small cell lung cancer (NSCLC).
A total of 472 patients who received whole-brain radiotherapy (WBRT) alone with 5 × 4 Gy or 10 × 3 Gy for brain metastasis from NSCLC were included in this retrospective study. In addition to the number of involved extracranial organs, 6 further potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), number of brain metastases, and the interval from cancer diagnosis to WBRT. Subgroup analyses were performed for patients with metastatic involvement of one (lung vs. bone vs. other metastasis) and two (lung + bone vs. lung+lymph nodes vs. other combinations) extracranial organs.
The survival rates at 6 months of the patients with involvement of 0, 1, 2, 3, and ≥ 4 extracranial organs were 52, 27, 17, 4, and 14%, respectively (p<0.001). On multivariate analysis, the number of involved extracranial organs remained significant (risk ratio 1.32; 95% confidence interval 1.19-1.46; p<0.001). Age <65 years (p=0.004), KPS ≥ 70 (p<0.001), and only 1-3 brain metastases (p=0.022) were also significantly associated with survival in the multivariate analysis. In the separate analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the pattern of extracranial organ involvement.
The number of involved extracranial organs is an independent prognostic factor of survival in patients with brain metastasis from NSCLC, irrespective of the pattern of extracranial organ involvement.
本研究旨在探讨非小细胞肺癌脑转移患者颅外受累器官数目的潜在预后价值。
本回顾性研究共纳入 472 例接受全脑放疗（WBRT）的非小细胞肺癌脑转移患者，放疗方案为 5×4 Gy 或 10×3 Gy。除了颅外受累器官数目外，还研究了其他 6 个可能的预后因素，包括 WBRT 方案、年龄、性别、卡氏功能状态评分（KPS）、脑转移瘤数目和 WBRT 与癌症诊断之间的时间间隔。对颅外转移器官受累 1 个（肺 vs. 骨 vs. 其他转移）和 2 个（肺+骨 vs. 肺+淋巴结 vs. 其他组合）的患者进行了亚组分析。
受累 0、1、2、3 和≥4 个颅外器官的患者 6 个月生存率分别为 52%、27%、17%、4%和 14%（p<0.001）。多因素分析显示，颅外受累器官数目仍具有显著意义（风险比 1.32；95%置信区间 1.19-1.46；p<0.001）。年龄<65 岁（p=0.004）、KPS≥70（p<0.001）和仅有 1-3 个脑转移瘤（p=0.022）也是多因素分析中与生存相关的显著因素。在单独分析颅外受累器官数为 1 个和 2 个的患者时，根据颅外受累器官的模式，生存情况无显著差异。
颅外受累器官数目是影响非小细胞肺癌脑转移患者生存的独立预后因素，与颅外受累器官的模式无关。
