Jeong Seong, Poudyal Soniya, Klagges Sabine, Kuhnt Thomas, Papsdorf Kirsten, Hambsch Peter, Wach Johannes, Güresir Erdem, Nägler Franziska, Rühle Alexander, Nicolay Nils H, Seidel Clemens
Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany.
Cancers (Basel). 2023 Oct 4;15(19):4845. doi: 10.3390/cancers15194845.
Brain metastases (BM) cause relevant morbidity and mortality in cancer patients. The presence of cerebrovascular diseases can alter the tumor microenvironment, cellular proliferation and treatment resistance. However, it is largely unknown if the presence of distinct cerebrovascular risk factors may alter the prognosis of patients with BM.
Patients admitted for the radiotherapy of BM at a large tertiary cancer center were included. Patient and survival data, including cerebrovascular risk factors (diabetes mellitus (DM), smoking, arterial hypertension, peripheral arterial occlusive disease, hypercholesterolemia and smoking) were recorded.
203 patients were included. Patients with DM ( = 39) had significantly shorter overall survival (OS) (HR 1.75 (1.20-2.56), = 0.003, log-rank). Other vascular comorbidities were not associated with differences in OS. DM remained prognostically significant in the multivariate Cox regression including established prognostic factors (HR 1.92 (1.20-3.06), = 0.006). Furthermore, subgroup analyses revealed a prognostic role of DM in patients with non-small cell lung cancer, both in univariate (HR 1.68 (0.97-2.93), = 0.066) and multivariate analysis (HR 2.73 (1.33-5.63), = 0.006), and a trend in melanoma patients.
DM is associated with reduced survival in patients with BM. Further research is necessary to better understand the molecular mechanisms and therapeutic implications of this important interaction.
脑转移瘤（BM）在癌症患者中会导致相关的发病率和死亡率。脑血管疾病的存在可改变肿瘤微环境、细胞增殖及治疗耐药性。然而，不同的脑血管危险因素是否会改变BM患者的预后在很大程度上尚不清楚。
纳入一家大型三级癌症中心因BM接受放疗的患者。记录患者及生存数据，包括脑血管危险因素（糖尿病（DM）、吸烟、动脉高血压、外周动脉闭塞性疾病、高胆固醇血症和吸烟）。
共纳入203例患者。患有DM（n = 39）的患者总生存期（OS）显著缩短（HR 1.75（1.20 - 2.56），P = 0.003，对数秩检验）。其他血管合并症与OS差异无关。在包括既定预后因素的多变量Cox回归中，DM在预后方面仍具有显著意义（HR 1.92（1.20 - 3.06），P = 0.006）。此外，亚组分析显示DM在非小细胞肺癌患者中具有预后作用，在单变量分析（HR 1.68（0.97 - 2.93），P = 0.066）和多变量分析（HR 2.73（1.33 - 5.63），P = 0.006）中均如此，在黑色素瘤患者中也有此趋势。
DM与BM患者生存率降低相关。有必要进一步研究以更好地理解这种重要相互作用的分子机制和治疗意义。
