Prognostic Factors In Patients With Brain Metastasis Fron Non-small Cell Lung Cancer Simultaneous Stereotactic Radiotherapy Combined With Targeted Therapy

Objective To investigate the influential factors of prognosis of patients through analysis of related clinical data of patients with non-small cell lung cancer(NSCLC)with brain metastases treated by simultaneous stereotactic radiotherapy combined with targeted drug therapy.Materials and Methods From October,2011 to Septmber,2016,75 patients with non-small cell lung cancer with brain metastases who underwent stereotactic radiotherapy were selected from the Cancer Gamma Knife Treatment Center of the Fifth Affiliated Hospital of Zhengzhou University,of whom,32 cases were positive in detection of epidermal growth factor receptor(EGFR)mutation results.The patients were treated with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIS),and the prognosis of patients with non-small cell lung cancer with brain metastases was studied in terms of gender,age,karnofsky performance status(KPS)score / function status,type of lung tumor,control of primary tumor,specific location,size andnumber of brain metastases,and comprehensive treatment measures.Results All of the 75 patients with non-small cell lung cancer with brain metastases who underwent stereotactic radiotherapy received follow-up visit,6-8 weeks after treatment chest and abdomen combined with X-ray computed tomography enhanced examination,12 weeks after treatment,and re-examination was made through head enhanced magnetic resonance imaging(MRI),17 cases(22.7%)complete response,49 cases(65.3%)parital response,6 cases(8.0%)stable disease,and 3 cases(4.0%)progression disease,with tumor local control rate of 96%.Single-factor analysis was conducted in Log-rank inspection,and the results showed that the influential factors for prognosis of non-small cell lung cancer patients with brain metastases were KPS score,pathological results of primary lung cancer,amount of brain metastases,specific size,and comprehensive treatment measures.The patients treated by simultaneous stereotactic radiotherapy combined with targeted therapy had the survival time of 1 year and 3 years,in which the 3-year survival time difference was statistically significant(P <0.05).Conclusions 1.The factors affecting prognosis were KPS score,pathological results of primary lung cancer,amount of brain metastases,specific size,and comprehensive treatm-ent measures.2.The effects of combined targeting therapy in patients were better than simple sim-ultaneous treatment for the patients of target gene mutations;The survival time of combined targeting therapy in patients was longer than the genetically non mutant patients obviously.3.Simultaneous stereotactic radiotherapy was a safe and effective means for treatm-ent of non-small cell lung cancer with brain metastases.