Niemiec Milena, Głogowski Maciej, Tyc-Szczepaniak Dobromira, Wierzchowski Marek, Kępka Lucyna
Department of Radiation Oncology, M. Skłodowska-Curie Memorial Cancer Center and Institut of Oncology, ul. Roentgena 5, 02-776 Warsaw, Poland.
Department of Thoracic Surgery, M. Skłodowska-Curie Memorial Cancer Center and Institut of Oncology, Warsaw, Poland.
Rep Pract Oncol Radiother. 2011 Feb 1;16(2):49-53. doi: 10.1016/j.rpor.2011.01.002. eCollection 2011.
Long-term survival of lung cancer patients with brain metastases (BM) is very rare. Our aim is to report the characteristics of patients who survived for at least three years after a BM diagnosis.
Nineteen lung cancer patients who had survived ≥3 years after a BM diagnosis were identified in our database. Seven (37%) had undergone whole-brain radiotherapy (WBRT) only, five (26%) BM surgery + WBRT, three (16%) BM surgery + WBRT + BM radiosurgery, and four (21%) no WBRT (one, surgery; one, radiosurgery; two, BM surgery + radiosurgery). Their characteristics were compared with historical data for 322 lung cancer patients with BM (control group, CG), who had received WBRT between 1986 and 1997.
Median survival from BM in long survivors group was 73 months (in CG - 4 months). Characteristics comparison: median age 55 vs. 58 (CG), p = 0.16; female sex 68% vs. 28% (CG), p = 0.003; RTOG/RPA class 1 - 75% vs. 13% (CG), p = 0.00001; adenocarcinoma histology 84% vs. 24% (CG), p < 0.00001; control of primary tumor 95% vs. 27% (CG), p < 0.00001; extracranial metastases 0 vs. 26% (CG), p = 0.01; single BM 63% vs. 9% (CG), p = 0.00001; surgery of BM 53% vs. 14% (CG), p = 0.00001.
Beside prognostic factors already recognized as favorable in patients with BM, the adenocarcinoma histology and female sex were prevalent in long-term survivors of BM from lung cancer.
肺癌脑转移（BM）患者的长期生存极为罕见。我们的目的是报告BM诊断后存活至少三年的患者的特征。
在我们的数据库中识别出19例BM诊断后存活≥3年的肺癌患者。其中7例（37%）仅接受了全脑放疗（WBRT），5例（26%）接受了BM手术+WBRT，3例（16%）接受了BM手术+WBRT+BM立体定向放射外科治疗，4例（21%）未接受WBRT（1例接受手术；1例接受立体定向放射外科治疗；2例接受BM手术+立体定向放射外科治疗）。将他们的特征与1986年至1997年间接受WBRT的322例肺癌BM患者的历史数据（对照组，CG）进行比较。
长期存活组中BM后的中位生存期为73个月（CG组为4个月）。特征比较：中位年龄55岁对58岁（CG组），p = 0.16；女性比例68%对28%（CG组），p = 0.003；放射治疗肿瘤学组（RTOG）/放射肿瘤学协作组（RPA）1级75%对13%（CG组），p = 0.00001；腺癌组织学类型84%对24%（CG组），p < 0.00001；原发肿瘤控制率95%对27%（CG组），p < 0.00001；颅外转移0对26%（CG组），p = 0.01；单个BM 63%对9%（CG组），p = 0.00001；BM手术率53%对14%（CG组），p = 0.00001。
除了已被认为对BM患者有利的预后因素外，腺癌组织学类型和女性在肺癌BM的长期存活者中更为普遍。
