Risk Factors And Prognosis Of Stage ?B~? Lung Adenocarcinoma With Brain Metastases

Objective: To investigate the risk factors and prognostic factors of brain metastases in patients with stage ?B~?lung adenocarcinoma and provide an important reference for clinical screening of high-risk patients with brain metastases and selecting the best tre atment.Method: From January 2010 to January 2014 in our hospital for the first time in the treatment of 361 cases of pathologically diagnosed as stage ? B ~? lung adenocarcinoma of the clinical and pathological data were retrospectively studied using single factor and Logistic regression model analysis of brain metastases Risk factors;then the clinical data and survival data of patients with brain metastases were analyzed.Univariate and multivariate analysis were performed using Kalpan-Meier and COX regression models to find the prognostic factors in patients with brain metastases.The Kaplan-Meier method was used to estimate the survival rate,Log-rank survival rate test,and draw the survival curve.Results:(1)Univariate analysis showed that a ge? 60 years,smoking,primary tumor in the lung,poorly differentiated,stage ?,with mediastinal lymph node metastasis associated with brain metastases of stage ? B ~? lung adenocarcinoma(p <0.05).Multivariate analysis showed that the risk factors of brai n metastasis in stage ? B-? lung adenocarcinoma(p<0.05)were the primary tumors in the upper lobe of lung,poorly differentiated,age? 60 years,with mediastinal lymph node metastasis.(2)Univariate analysis showed that Karnofsky performance status(KPS)s cores and treatment methods had an effect on the overall survival of patients with stage ?B-? lung adenocarcinoma after brain metastasis(p<0.05)Factor analysis showed that KPS score and treatment before brain metastasis were independent factors influencing the prognosis of stage ? B-? lung adenocarcinoma patients with brain metastasis(p<0.05).(3)There was no case of metastasis in brain metastasis group and brain metastasis group survived Five patients(3.3%)had a median survival of 16 months.The surviva l rates at 6,12 and 24 months were 96.1%,68.4% and 27.6%,respectively.The median survival time from discovery of brain metastases to death was 9 The survival rates at 6,12 and 24 months after the brain metastases were 60.5%,32.2% and 9.9% respectivel y.In the no brain metastasis group,11 patients(5.3%)were lost and 13(6.2%)survived,The median survival time was 21 months,12,24-month survival rate was 94.4%,68.7% and 39.9%.Conclusion:The median interval between diagnosis and brain metastases of patients with stage ? B-? lung adenocarcinoma was 5 months,and the prognosis of patients with brain metastasis was significantly lower than those without brain metastasis.? 60 years of age,mediastinal lymph node metastasis and other high risk factors for brain metastases of stage ? B~ ? lung adenocarcinoma,KPS score before treatment of brain metastases,treatment is an independent factor affecting the prognosis of patients with stage ? B~? lung adenocarcinoma with brain metastases,This paper hopes to follow up th e high-risk patients and make intervention as early as possible to improve the quality of life of patients with brain metastases;in the treatment of patients with brain metastases,should follow the multi-disciplinary treatment model,combined with the actual situation of patients,to develop personalized treatment strategies to achieve best treatment.