Santini Daniele, Barni Sandro, Intagliata Salvatore, Falcone Alfredo, Ferraù Francesco, Galetta Domenico, Moscetti Luca, La Verde Nicla, Ibrahim Toni, Petrelli Fausto, Vasile Enrico, Ginocchi Laura, Ottaviani Davide, Longo Flavia, Ortega Cinzia, Russo Antonio, Badalamenti Giuseppe, Collovà Elena, Lanzetta Gaetano, Mansueto Giovanni, Adamo Vincenzo, De Marinis Filippo, Satolli Maria Antonietta, Cantile Flavia, Mancuso Andrea, Tanca Francesca Maria, Addeo Raffaele, Russano Marco, Sterpi Michelle, Pantano Francesco, Vincenzi Bruno, Tonini Giuseppe
Department of Medical Oncology, University of Cagliari, Cagliari, Italy.
Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
Sci Rep. 2015 Dec 22;5:18670. doi: 10.1038/srep18670.
We conducted a large, multicenter, retrospective survey aimed to explore the impact of tumor bone involvement in Non-Small Cell Lung Cancer.Data on clinical-pathology, skeletal outcomes and bone-directed therapies for 661 deceased patients with evidence of bone metastasis were collected and statistically analyzed. Bone metastases were evident at diagnosis in 57.5% of patients. In the remaining cases median time to bone metastases appearance was 9 months. Biphosphonates were administered in 59.6% of patients. Skeletal-related events were experienced by 57.7% of patients; the most common was the need for radiotherapy. Median time to first skeletal-related event was 6 months. Median survival after bone metastases diagnosis was 9.5 months and after the first skeletal-related event was 7 months. We created a score based on four factors used to predict the overall survival from the diagnosis of bone metastases: age >65 years, non-adenocarcinoma histology, ECOG Performance Status >2, concomitant presence of visceral metastases at the bone metastases diagnosis. The presence of more than two of these factors is associated with a worse prognosis.This study demonstrates that patients affected by Non-Small Cell Lung Cancer with bone metastases represent a heterogeneous population in terms of risk of skeletal events and survival.
我们开展了一项大型多中心回顾性调查，旨在探究肿瘤骨转移对非小细胞肺癌的影响。收集了661例有骨转移证据的已故患者的临床病理、骨骼转归及骨靶向治疗数据，并进行了统计分析。57.5%的患者在诊断时即有明显骨转移。其余患者出现骨转移的中位时间为9个月。59.6%的患者接受了双膦酸盐治疗。57.7%的患者发生了骨相关事件；最常见的是需要放疗。首次骨相关事件的中位时间为6个月。骨转移诊断后的中位生存期为9.5个月，首次骨相关事件后的中位生存期为7个月。我们基于四个因素创建了一个评分系统，用于预测自骨转移诊断后的总生存期：年龄>65岁、非腺癌组织学类型、东部肿瘤协作组（ECOG）体能状态>2、骨转移诊断时伴有内脏转移。存在两个以上这些因素与较差的预后相关。本研究表明，患有骨转移的非小细胞肺癌患者在骨骼事件风险和生存方面代表了一个异质性群体。
