Treatment And Prognosis Of112Patients With Brain Metastases From Non-small Cell Lung Cancer

Objective: This essay is a retrospective analysis of prognostic factors in patientswith brain metastases from non-small cell lung cancer,aimmed to evaluate the efficacyof different multidisciplinary treatment to brain metastases.Methods:From March2009to March2012,112patients with brain metastasesfrom non-small cell lung cancer received whole brain radiation therapy(WBRT),withcomplete clinical date, were retrospecively analysed. The clinical characteristics ofthese112patients, combined with follow-up data were analyzed,including WBRTalone treatment in29cases, WBRT combined systemic chemotherapy in39patients,WBRT combined targeted therapy in27cases; surgery combined with WBRT in17cases. SPSS statistical software was used for analysing the efficacy and survivalindicators in univariate and multivariate methods.We used χ2test and logistic regressionanalysis to compare different factors on the effective rate(RR) and disease controlrate(DCR);used Kaplan-Meier survival analysis method and the log-rank test (Log-rank)to analyse the factors affecting intracranial median progression-free survival (PFS) andmedian overall survival (OS);used Cox proportional hazards model for multivariateanalysis.Results:112patients were evaluable for response,13patients were completeremission (CR),64patients were partial remission (PR),17patients were stable disease(SD),18patients were progressive disease (PD), the efficiency (RR) was68.8%andthe disease control rate (DCR) was83.9%. Univariate analysis for Efficiency (RR) anddisease control rate (DCR) showed differences in KPS score and treatments,thedifferences were statistically significant (P <0.05).Multivariate regression analysisshowed that KPS score and treatment methods are independent factors.The intracranial median progression-free survival (PFS) of the whole112patients was six months, andthe median overall survival (OS) was10.8months, half a year survival rate was76.7%,1-year survival rate was42.8%,2years survival rate was7.1%. Univariate analysisshowed that the differences of PFS in KPS score, primary pulmonary tumor condition,extracranial metastases, treatment methods and short-term efficacy were statisticallysignificant (P <0.05). Multivariate analysis showed that KPS score, lung primary tumorcondition, treatment methods and short-term efficacy were independent prognosticfactors for survival. Univariate analysis showed that the differences of OS in KPS score,primary pulmonary tumor condition, extracranial metastases, treatment methods andshort-term efficacy were statistically significant (P<0.05).Multivariate analysis showedthat KPS score, lung primary tumor condition, treatment methods and short-termefficacy were independent prognostic factors for survival.Conclusion:1.In efficiency and suivial,whole brain radiation therapy(WBRT)combined with surgery, chemotherapy or targeted therapy are significantly better thanWBRT only.2.KPS score and lung primary tumor situation are important prognosticfactors for patients with brain metastases from non-small cell lung cancer.3Short-termefficacy has significant impact on survival.