Survival Status And Prognostic Factors Of Leptomeningeal Metastases From Lung Adenocarcinoma

Background and ObjectiveAutopsy studies in NSCLC show a 41 % incidence of BM and a 9% incidence of LM.Lung adenocarcinoma is the most common pathology type of LM from NSCLC(84-97%).LM typically presents a devastating complication of CNS with poor survival.The median survival of patients without treatment is between four to six weeks.Improved teatmrent of NSCLC in particular the use of EGFR-TKIs and advances in diagnostic imaging have led to an apparent increase in the number of patients diagnosed with LM.However,due to the presence of BBB,anti-tumor drug CSF ermeability is poor,LM treatment is limited,the prognosis for LM is poor.Clinical research on the treatment and prognosis of LM from lung adenocarcinoma has been increasing in recent years.To understand the prognostic factors of LM from lung adenocarcinoma,is of great significance to the better understanding of the disease,determine the prognosis and choose a reasonable treatment regimen.However,the prognostic factors of LM from lung adenocarcinoma have not yet been fully defined.To investigate the prognostic factors of patients with leptomeningeal metastases from lung adenocarcinoma and to provide an objective basis for the selection of clinical treatment decision-making,we retrospectively analyzed the clinical data of 65 patients with leptomeningeal metastases from lung adenocarcinoma with complete follow-up data.MethodsThe clinical data of patients with leptomeningeal metastases from lung adenocarcinoma admitted to the Department of Oncology,People's Hospital of Zhengzhou University from January 2008 to January 2015 were followed up.The data of patients with complete follow-up data were established.SPSS21.0 was used for statistical data.Kaplan-Meier method for survival analysis,mapping survival curve,single factor analysis was performed using the Log-rank test,Cox regression model for multivariate regression analysis,We retrospectively analyzed the survival status of 65 cases of lung adenocarcinoma with leptomeningeal metastases from lung adenocarcinoma and the related factors of prognosis.ResultsThe median survival time of the 65 patients was 7.4 months,and the 1-year survival rate was 6.2%(4/65).Univariate analysis demonstrated that gender,age,smoking history,timing of LM,and whether combine with brain metastasis had no significant correlation with the OS(all P > 0.05),but the ECOG PS score,ventriculoperitoneal shunt,EGFR-TKIs targeted therapy,SC,WBRT,clinical signs of eptomeningeal metastases and EGFR gene status were associated with the OS(all P < 0.05).Multivariate analysis showed that EGFR gene status,ECOG PS score,SC and V-P shunt were independent prognostic factors of the prognosis of patients with LM from lung adenocarcinoma(all P<0.05).ConclusionThe overall prognosis of leptomeningeal metastases from lung adenocarcinoma is poor.The prognosis of leptomeningeal patients with EGFR mutation is relatively good.EGFR-TKI targetedtherapy,SC and V-P shunt can prolong the survival time and improve the prognosis of patients with LM metastasis from lung adenocarcinoma.