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肺癌脑转移的结局

Outcomes of Brain Metastasis from Lung Cancer.

作者信息

Mobley James M, Phillips Kerry I, Chen Quan, Reusch Ellen, Reddy Niharika, Magsam Julia B, McLouth Laurie E, Huang Bin, Villano John L

机构信息

Division of Medical Oncology, Department of Internal Medicine, University of Kentucky Markey Cancer Center, Lexington, KY 40536, USA.

Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA.

出版信息

Cancers (Basel). 2025 Jan 14;17(2):256. doi: 10.3390/cancers17020256.

Abstract

: Little information has been published on patients diagnosed with brain metastasis secondary to lung cancer. Correlating outcome patterns (hospice care, lost to follow-up, death before hospice care or treatment) and specific characteristics of treated and untreated patients may identify subsets of patients who may benefit from treatment. : We evaluated data from the Kentucky Cancer Registry and identified 284 cases who were diagnosed with brain metastasis secondary to non-small cell lung cancer (NSCLC) between 1 August 2016, and 31 December 2019. We evaluated type and timing of treatment received, as well as focused on those patients who did not receive treatment. For those patients who did not receive treatment, various characteristics that may have impacted their decision or ability to undergo follow-up were also evaluated. This included social history, disease burden, as well as oncology treatment timelines. Lastly, due to the high smoking rate in Kentucky, we conducted an analysis of patient tobacco use. : Our results show that 61 cases (21.8%) never received treatment for lung cancer with brain metastasis. Further analysis of the non-treated cases demonstrated that 19 cases (31.1%) never met with an oncology team while in the hospital or after discharge; 14 of the 61 cases (23.0%) were too sick to receive treatment and died prior to having the option of treatment; and 47 of the 61 cases (77.0%) may have had the option of treatment but declined. : Historically, patients with brain metastases have faced poor prognoses and limited treatment options. However, advancements in systemic chemoimmunotherapy and targeted therapies have introduced new treatment possibilities, offering improved symptom control and the potential for prolonged survival. This analysis is crucial for identifying potential barriers to care, optimizing resource allocation, and guiding future research.

摘要

关于肺癌继发脑转移患者的公开信息较少。关联结局模式(临终关怀、失访、临终关怀或治疗前死亡)以及接受治疗和未接受治疗患者的具体特征,可能会识别出可能从治疗中获益的患者亚组。

我们评估了肯塔基州癌症登记处的数据,确定了284例在2016年8月1日至2019年12月31日期间被诊断为非小细胞肺癌(NSCLC)继发脑转移的病例。我们评估了所接受治疗的类型和时间,并关注那些未接受治疗的患者。对于那些未接受治疗的患者,还评估了可能影响其接受后续治疗的决定或能力的各种特征。这包括社会史、疾病负担以及肿瘤治疗时间线。最后,由于肯塔基州的吸烟率很高,我们对患者的烟草使用情况进行了分析。

我们的结果显示,61例(21.8%)肺癌继发脑转移患者从未接受过治疗。对未治疗病例的进一步分析表明,19例(31.1%)在住院期间或出院后从未与肿瘤学团队会面;61例中的14例(23.0%)病情太重无法接受治疗,在有治疗选择之前就死亡了;61例中的47例(77.0%)可能有治疗选择但拒绝了。

从历史上看,脑转移患者的预后较差,治疗选择有限。然而,全身化学免疫疗法和靶向疗法的进展带来了新的治疗可能性,提供了更好的症状控制和延长生存的潜力。这项分析对于识别护理的潜在障碍、优化资源分配以及指导未来研究至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/706a/11764313/437a7bd04578/cancers-17-00256-g001.jpg

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