| Objective:The clinical data of cyberknife were collected for patients with brain metastases from lung cancer treated by cyberknife,describe the basic situation of brain metastases from lung cancer,analyze the disease characteristics,compare the changes of tumor markers,and study factors that could influence short-term curative effet and prognosis,which could provide theoretical basis for cyberknife for better application in clinical practice.Methods:185 patients treated by cyberknife for the first time were collected clinical date from July 2012 to December 2018,who were brain metastases from lung cancer.Describe the basic situation of patients,study the disease characteristics of patients,compare the changes of tumor markers,analyze the short-term curative effect and prognosis and its influencing factors.Epi Data 3.1 and SPSS 24.0 were used to enter,collect and analyze the clinical data.The disease characteristics and the short-term curative effect of patients with brain metastases from lung cancer were analyzed byχ~2test;the changes of tumor markers in patients with brain metastases from lung cancer were analyzed by Friedman rank sum test;log rank test and Cox regression were used to analyze the prognosis of patients with brain metastases from lung cancer.Results:1.The basic situation of patients with brain metastases from lung cancer:135 were male,accounting for 73.0%and 50 were female,accounting for 27.0%.The average age was 61 years old,including 7 patients<40 years old,accounting for 3.8%;16patients aged 40-49,accounting for 8.6%;56 patients aged 50-59,accounting for 30.3%;and 106 patients≥60 years old,accounting for 57.3%.The patients who were brain metastases from lung cancer with clear KPS score were 104,and among them,35patients with KPS<80,accounting for 33.7%;69 patients with KPS≥80,accounting for 66.3%.104 patients were adenocarcinoma for pathological types of primary lesions,accounting for 56.2%;49 non adenocarcinoma patients,accounting for 26.5%;and 32unknown types,accounting for 17.3%.2.Analysis of the characteristics of patients with brain metastases from lung cancer:the proportion of lung cancer diagnosed with the same period of brain metastases was20.2%in the patients with primary tumor treatment,but the proportion of patients without primary tumor treatment was 87.3%,whether the same diagnosis of brain metastases was related to whether treat for primary tumor(χ~2=79.431,P<0.001).In the patients whose primary tumor were adenocarcinoma,the proportion of extracranial metastases was 50.0%but the proportion was 32.7%in the patients with non adenocarcinoma.The primary pathological type was related to the extracranial metastases(χ~2=4.059,P=0.044).3.Tumor markers of patients with brain metastases from lung cancer:the content of CA724 in patients with brain metastases from lung cancer was not completely the same before,3 months and 6 months after cyberknife treatment(P=0.024),and it was found that CA724 was increased before and 6 months after cyberknife treatment(P=0.008).4.The short-term curative effect of brain metastases from lung cancer:92 patients had 3 months follow-up data,the local control rate was 76.1%in 3 months and the effective rate was 51.1%.61 patients had 6 months follow-up data,the local control rate was 57.4%and the effective rate was 18.0%.The general situation,past history,primary tumor,metastases and treatment of patients had no effect on the efficacy of 3 months and 6 months(P>0.05).5.Prognosis analysis of patients with brain metastases from lung cancer:among the patients with brain metastasis from lung cancer,the average survival time of was23.2(19.0,27.4)months,and the median survival time was 15.0(11.2,18.9)months.The 1-year survival rate was 56.3%,the 2-year was 28.8%,and the 3-year was 19.0%.The single factor analysis showed that there was significant difference in prognosis among patients with different hypertension history,number of intracranial metastases and neurologic symptoms(P<0.05).Multivariate Cox regression analysis showed that the prognosis of patients with brain metastases from lung cancer with different history of hypertension and neurological symptoms was significantly different(P<0.05).The risk of death in patients with brain metastasis from lung cancer with hypertension was statistically significant(P<0.05).The patients with hypertension history were 1.804times(P=0.024,HR=1.804).The risk of death in patients with brain metastasis from lung cancer with mental disorders was 3.267 times higher than that of headache,dizziness,nausea and vomiting(P=0.002,HR=3.267).Conclusions:1.The patients with brain metastasis from lung cancer treated with cyberknife were mostly middle and old,mainly male.2.The primary treatment of brain metastasis from lung cancer could reduce the incidence of brain metastasis in the same period.3.The patients with brain metastasis from lung adenocarcinoma were more likely to have extracranial metastases than those of non lung adenocarcinoma.4.CA724 increased 6 months after radiotherapy in patients with brain metastasis of lung cancer.5.Hypertension history and neurologic symptoms might be independent factors influencing prognosis of brain metastasis from lung cancer. |
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