Bacha Saoussen, Cherif Hela, Rabaa Della, Habibech Sonia, Cheikhrouhou Sana, Racil Hager, Chaouch Naouel, Megdiche Mohamed Lamine, Chabbou Abdellatif
Tunis Med. 2018 Mar;96(3):165-171.
The prognosis of patients with non-small cell lung cancer (NSCLC) with brain metastasis (BM) is dark. The aim of our study was to analyze the prognostic factors after the onset of BM and to evaluate the current management of BM.
We conducted a retrospective study that included 100 patients diagnosed with primary NSCLC with BM. Survival was analysed using Kaplan Meier curve.Univariate survival analysis was performed to assess the prognostic value of sex, age, gender, performance status, histologic type, tumor size, BM features and treatment modality of primary lung tumor and BM.
The median age was 57 years; 94% of the patients were male. Most patients (85%) had a PS of (0-1). BM were unique in 54% of cases, symptomatic in 40% of cases and synchronous in 72% of cases. Chemotherapy was administered to 78% of patients; pulmonary tumor surgery was performed in 5% of patients. BM surgery and panencephalic irradiation were performed in 13% and 86% of patients, respectively. The median overall survival after NSCLC diagnosis was 13.33 months. The median overall survival after BM was 10.6 months. The Control of the primary tumor was the only factor associated with better overall survival (64.95 months Vs 10.6 months (p=0.02)).
Pulmonary tumor control with complete surgical excision is predictive of better overall survival in patients with NSCLC and BM.
非小细胞肺癌（NSCLC）脑转移（BM）患者的预后不佳。本研究旨在分析脑转移发生后的预后因素，并评估目前对脑转移的治疗情况。
我们进行了一项回顾性研究，纳入了100例诊断为原发性NSCLC伴脑转移的患者。采用Kaplan-Meier曲线分析生存率。进行单因素生存分析以评估性别、年龄、体能状态、组织学类型、肿瘤大小、脑转移特征以及原发性肺肿瘤和脑转移的治疗方式的预后价值。
中位年龄为57岁；94%的患者为男性。大多数患者（85%）的体能状态评分为（0-1）。54%的病例脑转移为单发，40%有症状，72%为同时性脑转移。78%的患者接受了化疗；5%的患者进行了肺部肿瘤手术。分别有13%和86%的患者进行了脑转移瘤手术和全脑照射。NSCLC诊断后的中位总生存期为13.33个月。脑转移后的中位总生存期为10.6个月。原发性肿瘤的控制是与更好的总生存期相关的唯一因素（64.95个月对10.6个月（p=0.02））。
通过完整手术切除实现肺部肿瘤控制可预测NSCLC伴脑转移患者有更好的总生存期。
