Analysis Of Clinical Features And Prognosis Of Bone Metastasis From Non-small Cell Lung Cancer

[Objectives]Once bone metastasis occurs in patients with non-small cell lung cancer(NSCLC),the quality of life of the patients will be greatly reduced and the survival time will be greatly shortened.Although the role of radiotherapy,bisphosphonates and interventional therapy in the treatment of bone metastasis has been recognized in recent years,the overall effect is still unsatisfactory.There have been clinical trials of drugs targeting TGF-TGF,integrin,OPG,PTHrP and other new therapeutic targets,and research on the EMT-CTCs-MET transfer model is in full flow,but our understanding of its cellular and molecular mechanisms is still immature and many questions remain to be addressed.The purpose of this study was to investigate the clinical characteristics and prognostic factors of NSCLC with bone metastasis,and to provide assistance for the clinical treatment and clinical trials of NSCLC patients with bone metastasis.[Methods]Patients with non-small cell lung cancer with bone metastasis who were admitted to our hospital from June 2012 to June 2016 were included.All of these patients were pathologically or histologically diagnosed with NSCLC,and bone metastases were confirmed by at least two imaging studies in X-ray/CT/MRI/ECT/pet-ct.Clinical data of the patients were collected,including age,gender;history of smoking,presence of chronic disease,first diagnosis,pathological type,body mass index(BMI),ECOG score,clinical stage,number and location of bone metastases,occurrence of SREs and treatment,etc.Kaplan-meier survival analysis was used to obtain the median survival time,1-year and 3-year survival rates.The log-rank time-series test was used for univariate analysis,and Cox proportional risk regression model was used for multivariate analysis to identify the independent factors influencing the prognosis.P<0.05 was considered statistically significant.[Results]Finally,a total of 266 patients were included in the study.There were 172 males and 94 females.There were 139 cases with age<60 and 127 cases with age ?60.116 patients had chronic diseases,among which hypertension,diabetes and coronary atherosclerotic heart disease ranked the top three.136 patients had a history of smoking.There were 155 cases of adenocarcinoma,69 cases of squamous cell carcinoma,and 42 cases of other pathological types.Bone metastases were mainly located in the spine(171 cases),chest bones(151 cases)and pelvis(88 cases).The most common metastatic site in patients with adenocarcinoma was the spine(117 cases),while the most common metastatic site in patients with squamous cell carcinoma was the thoracic skeleton(34 cases).There were 134 patients with SREs,of which the most common SREs was radiotherapy intervention in patients with bone metastasis(120 cases),followed by pathological fracture(34 cases).The 266 patients with NSCLC with bone metastasis had a median survival time of 380 days,a 1-year survival rate of 55.3%,and a 3-year survival rate of 15.4%.Gender,age,history of chronic disease,smoking history,and treatment had no significant effect on the prognosis of NSCLC with bone metastasis(P>.05).Univariate survival analysis showed that pathological type,BMI,number of bone metastases,clinical stage,ECOG score and the presence or absence of SREs were significantly correlated with the prognosis of NSCLC patients with bone metastases(P<0.05),which were the prognostic factors of NSCLC patients with bone metastases.Multivariate regression analysis showed that clinical staging,BMI,number of bone metastases and whether or not SREs occurred had statistically significant prognostic effects on patients of NSCLC with bone metastases(P<0.05),which were independent prognostic factors for NSCLC patients with bone metastases.[Conclusions and Significance]This study found that pathological type,BMI,ECOG score,clinical stage,number of bone metastases,and the presence or absence of SREs influenced the prognosis of NSCLC patients with bone metastases.BMI,clinical stage,number of bone metastases,and presence of SREs were independent prognostic factors for NSCLC patients with bone metastases.