Objective:The clinical data of 139 patients with brain metastases(BMS)from non-small cell lung cancer(NSCLC)were collected,including age,gender,Karnofsky performance score(KPS),pathological type,pattern of brain metastases(simultaneous brain metastases/metachronous brain metastases),recursive partitioning analysis(RPA),EGFR gene mutation status and treatment methods(Supportive support,radiotherapy,chemotherapy and targeted treatment)to find to find the prognostic factors of NSCLC BMS patients.At the same time,the impact of different treatment methods on the survival of patients is analyzed in order to choose the best treatment method,which will help the choice of clinical treatment methods and the hierarchical management of patients with NSCLC BMs.Methods:A total of 139 patients with NSCLC BMs who were confirmed by pathology or cytology in the Affiliated Hospital of Chengde Medical College from June 2014 to December 2018 and met the inclusion and exclusion criteria were collected.The clinical data(age,gender,KPS score,pathological type,RPA grade,EGFR gene mutation status,brain metastasis pattern and treatment method)of 139 patients were retrospectively analyzed.The clinical data of 139 patients(age,sex,KPS score,pathological type,RPA,EGFR gene mutation status,brain metastasis pattern and treatment)were analyzed retrospectively.The patients were followed up by consulting electronic cases and telephone consultation.Based on the time when the patient was diagnosed with NSCLC as the starting point and the time when the brain metastasis was confirmed as the end point,the time interval between the occurrence of brain metastases was calculated.The time limit of 3 months was used to distinguish between simultaneous brain metastases and metachronous brain metastases.The overall survival time(OS)of patients was calculated from the date of diagnosis of brain metastasis as the starting point and the end of the date of death or follow-up deadline.The deadline of follow-up is April 2019.SPSS 22.0 statistical software was used for statistical analysis.Kaplan-Meier method was used to draw the survival curve and calculate the 6-month(6m),1-year(1a)and 2-year(2a)survival rates of patients with NSCLC BMs.Log-rank method was used to compare the survival rates between the groups,and Wilcoxon rank sum test or Kruskal-Wallis H test was used to compare the OS differences between the groups.Cox regression was used to perform single-factor analysis to select meaningful variables.Prognostic analysis to establish independent prognostic factors.The difference was statistically significant with P <0.05.Results:1.A total of 139 patients with NSCLC BMs were included in this study.The overall median OS was 11.2 months.Among them,pathological types,KPS scores,RPA grades,EGFR mutation status,brain metastasis patterns,and treatment methods were compared.Significance(P<0.05).The 6-month survival rate was 73.2%,the 1-year survival rate was 41.7%,and the 2-year survival rate was 5.5%.2.According to the age,gender,KPS score,pathological type,RPA,EGFR gene mutation status,brain metastasis pattern and treatment method,the factors affecting the prognosis of patients in this group were single factor.The pattern,RPA grade,EGFR mutation status,and treatment were related to the prognosis of NSCLC BMs(P<0.05),and age and gender were not related to the prognosis(P>0.05).3.Factors with statistical significance in univariate analysis were included in the COX regression.Multivariate analysis showed that: RPA rating(P<0.000),KPS score(P=0.001),treatment method(P<0.000),time to brain metastasis(P=0.032)and EGFR mutation status(P=0.021)are independent prognostic factors affecting survival.Among them,the treatment method(chemotherapy+radiotherapy+targeted therapy)has the most significant effect on survival rate.Conclusion:1.KPS score,RPA grade,EGFR mutation status,brain metastasis occurrence pattern and treatment method are related to the prognosis of patients with NSCLC BMs.KPS score,RPA grade,EGFR mutation status,brain metastasis pattern and treatment method are independent prognostic factors for NSCLC BMs.2.High KPS score,RPA grade Ⅰ,metachronous brain metastasis and EGFR-sensitive mutations are good prognostic factors in patients with NSCLC BMs.3.The treatment method has a significant effect on the survival of patients with NSCLC BMs.After chemotherapy+whole brain radiotherapy(WBRT)+targeted therapy,patients with NSCLC BMs can obtain longer survival. |