Faculty of Life Sciences and Medicine, King's College London, London, WC2R 2LS, UK.
Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Neurosurg Rev. 2022 Oct;45(5):3055-3066. doi: 10.1007/s10143-022-01832-1. Epub 2022 Jul 14.
The effects of smoking on survival in BM patients have yet to be reviewed and meta-analysed. However, previous studies have shown that smokers had a greater risk of dying from lung cancer compared to non-smokers. This meta-analysis, therefore, aimed to analyse the effects of cigarette smoking on overall survival (OS) and progression-free survival (PFS) in lung cancer BM patients. PubMed, Embase, Web of Science, Cochrane and Google Scholar were searched for comparative studies regarding the effects of smoking on incidence and survival in brain metastases patients up to December 2020. Three independent reviewers extracted overall survival (OS) and progression-free survival data (PFS). Random-effects models were used to pool multivariate-adjusted hazard ratios (HR). Out of 1890 studies, fifteen studies with a total of 2915 patients met our inclusion criteria. Amongst lung carcinoma BM patients, those who were smokers (ever or yes) had a worse overall survival (HR: 1.34, 95% CI 1.13, 1.60, I2: 72.1%, p-heterogeneity < 0.001) than those who were non-smokers (never or no). A subgroup analysis showed the association to remain significant in the ever/never subgroup (HR: 1.34, 95% CI 1.11, 1.63) but not in the yes/no smoking subgroup (HR: 1.30, 95% CI 0.44, 3.88). This difference between the two subgroups was not statistically significant (p = 0.91). Amongst lung carcinoma BM patients, smoking was associated with a worse OS and PFS. Future studies examining BMs should report survival data stratified by uniform smoking status definitions.
关于吸烟对 BM 患者生存影响的研究尚未进行综述和荟萃分析。然而，先前的研究表明，与不吸烟者相比，吸烟者死于肺癌的风险更高。因此，本荟萃分析旨在分析吸烟对肺癌 BM 患者总生存（OS）和无进展生存（PFS）的影响。检索了截至 2020 年 12 月的 PubMed、Embase、Web of Science、Cochrane 和 Google Scholar 中关于吸烟对脑转移患者发病率和生存影响的比较研究。三位独立的评审员提取了总生存（OS）和无进展生存数据（PFS）。使用随机效应模型对多变量调整后的危险比（HR）进行了汇总。在 1890 项研究中，有 15 项研究共 2915 例患者符合我们的纳入标准。在肺癌 BM 患者中，与非吸烟者（从不或否）相比，吸烟者（曾或是）的总生存（HR：1.34，95%CI 1.13，1.60，I2：72.1%，p 异质性 < 0.001）更差。亚组分析显示，这种关联在曾吸烟/从不吸烟亚组中仍然显著（HR：1.34，95%CI 1.11，1.63），但在是/否吸烟亚组中不显著（HR：1.30，95%CI 0.44，3.88）。这两个亚组之间的差异无统计学意义（p=0.91）。在肺癌 BM 患者中，吸烟与较差的 OS 和 PFS 相关。未来研究应报告根据统一的吸烟状况定义分层的生存数据。
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