Department of Oncology, the First Affiliated Hospital of Jinan University, Guangzhou City, Guangdong Province, P.R. China; Department of Radiotherapy, the Third Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, P.R. China.
Department of Radiotherapy, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, P.R. China.
World Neurosurg. 2022 Aug;164:e671-e680. doi: 10.1016/j.wneu.2022.05.036. Epub 2022 May 16.
Owing to the complexities of brain metastases (BMs), accurate and reliable prognostic and predictive factors remain critical roadblocks in patients with lung adenocarcinoma (LUAD) BMs who undergo stereotactic radiosurgery (SRS).
In total, 132 patients with LUAD BMs who underwent SRS were retrospectively analyzed; Cox proportional hazards analysis of imaging and clinical characteristics was used to identify independent predictors related to overall survival (OS) and progression-free survival (PFS).
Our data indicated that initial brain metastasis velocity (iBMV), Karnofsky performance score (KPS), and Rvol (the sum of peritumoral edema volume/cumulative intracranial tumor volume) could potentially be independent prognostic factors for OS. iBMV ≥2 (P = 0.000), KPS <80 (P = 0.042), and Rvol ≥5.7 (P = 0.017) were strongly associated with unsatisfactory OS. The KPS and BM contrast enhancement were also identified as independent prognostic factors for PFS. A higher KPS (P = 0.004) and homogeneous BM contrast enhancement (P = 0.026) were strongly associated with longer PFS.
Collectively, iBMV and Rvol are highly related to OS and could be used as potential prognostic indices in patients with LUAD BMs who underwent SRS. Furthermore, we also revealed that the KPS and BM contrast enhancement could be potential indices of PFS in LUAD BMs.
由于脑转移瘤（BMs）的复杂性，准确可靠的预后和预测因素仍然是接受立体定向放射外科（SRS）治疗的肺腺癌（LUAD）BMs 患者的关键障碍。
回顾性分析了 132 例接受 SRS 的 LUAD BMs 患者；采用 Cox 比例风险分析影像学和临床特征，以确定与总生存（OS）和无进展生存（PFS）相关的独立预测因素。
我们的数据表明，初始脑转移瘤速度（iBMV）、卡氏功能状态评分（KPS）和 Rvol（瘤周水肿体积/累积颅内肿瘤体积之和）可能是 OS 的独立预后因素。iBMV≥2（P=0.000）、KPS<80（P=0.042）和 Rvol≥5.7（P=0.017）与 OS 不满意强烈相关。KPS 和 BM 对比增强也被确定为 PFS 的独立预后因素。较高的 KPS（P=0.004）和均匀的 BM 对比增强（P=0.026）与更长的 PFS 强烈相关。
总的来说，iBMV 和 Rvol 与 OS 高度相关，可作为接受 SRS 治疗的 LUAD BMs 患者的潜在预后指标。此外，我们还揭示了 KPS 和 BM 对比增强可能是 LUAD BMs 中 PFS 的潜在指标。
