小细胞肺癌脑转移患者的化疗敏感性对其预后的影响：一项回顾性分析。
The Impact of Chemosensitivity on the Outcome of Brain Metastases in Small-Cell Lung Cancer: A Retrospective Analysis.
机构信息
Key Laboratory of Cancer Prevention and Therapy, Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
出版信息
Curr Oncol. 2022 Oct 21;29(10):7979-7986. doi: 10.3390/curroncol29100631.
PURPOSE
The purpose of this study was to investigate the prognostic differences between patients with small-cell lung cancer (SCLC) with different chemosensitivity to first-line chemotherapy who developed brain metastasis (BM) as the first site of progression.
METHODS
Patients with a BM after first-line treatment in the Tianjin Cancer Hospital were retrospectively analyzed. According to the time-free interval (TFI) between the completion of first-line chemotherapy and the onset of the BM, the patients were divided into the chemo-sensitive group (TFI ≥ 90 days, = 145) and the chemo-resistant group (TFI < 90 days, = 97). The survival time, which was calculated from the diagnosis of the BM, was analyzed after the onset of brain metastasis (BM-OS). Survival curves were plotted using the Kaplan-Meier method, and differences between groups were compared using the log-rank test.
RESULTS
In total, the median BM-OS was 8.4 months. The median BM-OS in the chemo-sensitive group was 8.8 months, and it was 8.0 months in the chemo-resistant group ( = 0.538). In patients without extracranial progression ( = 193), the median BM-OSes in the chemo-sensitive and chemo-resistant groups were 9.4 months and 9.7 months, respectively ( = 0.947). In patients with extracranial progression ( = 49), the median BM-OSes in the chemo-sensitive and chemo-resistant groups were 5.4 months and 4.2 months, respectively ( = 0.161). : After the development of a BM as the first site of progression following chemotherapy in patients with SCLC, the prognosis of chemo-sensitive patients was not necessarily superior to chemo-resistant patients, especially in patients without extracranial progression.
目的
本研究旨在探讨一线化疗后发生脑转移（BM）且以 BM 为首发进展部位的小细胞肺癌（SCLC）患者对化疗药物敏感性不同的预后差异。
方法
回顾性分析天津医科大学肿瘤医院一线治疗后发生 BM 的患者，根据一线化疗结束至 BM 发生的时间无复发生存期（TFI），将患者分为化疗敏感组（TFI≥90 天，n=145）和化疗耐药组（TFI<90 天，n=97）。从 BM 确诊开始计算生存时间，分析 BM 后生存时间（BM-OS）。采用 Kaplan-Meier 法绘制生存曲线，log-rank 检验比较组间差异。
结果
共纳入患者 242 例，BM-OS 的中位时间为 8.4 个月。化疗敏感组 BM-OS 的中位时间为 8.8 个月，化疗耐药组为 8.0 个月（=0.538）。在无脑外进展的患者（n=193）中，化疗敏感组和化疗耐药组的 BM-OS 分别为 9.4 个月和 9.7 个月（=0.947）。在外有颅进展的患者（n=49）中，化疗敏感组和化疗耐药组的 BM-OS 分别为 5.4 个月和 4.2 个月（=0.161）。结论：SCLC 患者化疗后以 BM 为首发进展部位，化疗敏感患者的预后不一定优于化疗耐药患者，尤其是无脑外进展的患者。
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