Zeng Yue-Can, Wu Rong, Wang Si-Liang, Chi Feng, Xing Rui, Cai Wei-Song, Fan Guo-Liang, Fan Yu-Chen, Zhong Wen-Zhao, Wu Li-Na, Chen Xiao-Dong, Chen Huan-Huan, Xiao Yu-Ping
Department of Medical Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang, 110022, China,
Med Oncol. 2014 Jul;31(7):48. doi: 10.1007/s12032-014-0048-y. Epub 2014 Jun 10.
This study was to evaluate the effect of serum CA125 level on the prognosis of patients with multiple brain metastases from non-small cell lung cancer before and after treatment of whole-brain radiotherapy. Sixty-six patients with multiple brain metastases from non-small cell lung cancer before and after treatment of radiotherapy were reviewed retrospectively. Radiotherapy was given to the whole brain using opposed 6MV lateral beams with a dose of 30 Gy in 15 fractions in 3 weeks. Elevated CA125 was defined as >35 U/mL. The survival rate was calculated using the Kaplan-Meier method, and the univariate and multivariate analyses were used to identify significant factors associated with prognosis, using a Cox proportional hazards model. During the median (range) follow-up of 1.25 (0.25-2.50) years, 62 patients died from non-small cell lung cancer; the 1-year cancer-specific survival (CSS) rate was 43.08 %. Thirty patients had a high CA125 level before chemoradiotherapy (>35U/mL), and their CSS rate was significantly worse than that in the remaining patients (P = 0.024). Multivariate analysis showed that CA125 level, number of metastases and total tumor volume were independent prognostic indicators for CSS, with a hazard ratio of 1.99, 1.67 and 2.02, respectively. The elevation of CA125 before treatment predicts a poor prognosis in patients with multiple brain metastases from non-small cell lung cancer before and after treatment of whole-brain radiotherapy.
本研究旨在评估血清CA125水平对非小细胞肺癌多发脑转移患者全脑放疗前后预后的影响。回顾性分析了66例非小细胞肺癌多发脑转移患者放疗前后的情况。采用6MV对穿侧野全脑放疗,剂量为30Gy,分15次,3周完成。CA125升高定义为>35U/mL。采用Kaplan-Meier法计算生存率,并使用Cox比例风险模型进行单因素和多因素分析,以确定与预后相关的显著因素。在中位(范围)1.25(0.25 - 2.50)年的随访期间,62例患者死于非小细胞肺癌;1年癌症特异性生存率(CSS)为43.08%。30例患者放化疗前CA125水平高(>35U/mL),其CSS率显著低于其余患者(P = 0.024)。多因素分析显示,CA125水平、转移灶数量和肿瘤总体积是CSS的独立预后指标,风险比分别为1.99、1.67和2.02。全脑放疗前后,非小细胞肺癌多发脑转移患者治疗前CA125升高预示预后不良。