Department of Radiation Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Oncol Res Treat. 2015;38(1-2):35-40. doi: 10.1159/000371501. Epub 2015 Jan 12.
The prognostic factors for patients with brain metastases from non-small cell lung cancer treated with whole brain radiotherapy (WBRT)-based combined modality therapy were investigated.
Out of 135 patients treated with WBRT, 47 (34.8%) received a radiation boost, 84 (62.2%) underwent systemic chemotherapy, and 39 (28.9%) were given epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).
The mean survival time was 9.3 months, and the 1-year and 2-year survival rates were 46.3 and 16.1%, respectively. In univariate analysis, improved survival was associated with age < 60 years, no extracranial metastasis, Karnofsky performance score ≥ 70, ≥ 3 cycles of chemotherapy after diagnosis of brain metastases, combined treatment with EGFR-TKIs, and no metastases in the cerebellum. In multivariate analysis, the above prognostic factors maintained significance with the exception of age. In an additional analysis of the 58 patients with 1-3 brain metastases, combination of WBRT with radiation boost was associated with better survival.
We confirm previously described prognostic factors. Moreover, we found the absence of cerebellar metastases to be an independent prognostic factor for favorable outcome.
本研究旨在探讨非小细胞肺癌脑转移患者接受全脑放疗（WBRT）联合治疗的预后因素。
在 135 例接受 WBRT 的患者中，47 例（34.8%）接受了放疗增敏，84 例（62.2%）接受了全身化疗，39 例（28.9%）接受了表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗。
中位生存时间为 9.3 个月，1 年和 2 年生存率分别为 46.3%和 16.1%。单因素分析显示，年龄<60 岁、无脑外转移、卡氏功能状态评分≥70、脑转移诊断后≥3 周期化疗、联合使用 EGFR-TKIs 和小脑无转移与生存改善相关。多因素分析中，除年龄外，上述预后因素仍具有显著意义。在对 58 例 1-3 个脑转移灶的患者进行的附加分析中，WBRT 联合放疗增敏与生存改善相关。
本研究证实了先前描述的预后因素，此外还发现小脑无转移是预后良好的独立预测因素。
