Prognosis and survival for 214 lung cancer patients with brain metastases / 中华神经科杂志

ABSTRACT

Objective To determine long-term survival of 214 patients of lung cancer with brain metastases and to detect the potential prognostic factors.Methods A retrospective review was pedormed evaluating patients diagnosed as lung cancer with brain metastasis from Jan 1992 to Dec 2001 at Zhejiang Cancer Hospital.Two hundred and fourteen cases were enrolled.All hospital records were thoroughly reviewed in a retrospective manner.The management of the brain metastases were as follows 8 patients underwent surgical resection and postoperative whole brain radiotherapy (WBRT); 2 cases received resection and chemotherapy; 10 had resection alone; 10 underwent WBRT alone,36 had chemotherapy alone; 15 received the combination of resection,chemotherapy and WBRT; 104 were performed with chemotherapy combined with WBRT; 29 had only supportive care.Survival time was measured from the date of the first treatment for malignancy to the date of death or the last follow-up.Seven further potential prognostic factors were investigated for survival including age,gender,T or N status,number of extra cranial metastases,pathological type and treatment modality.Statistical analysis was performed using the Kaplan-Meier method and Cox-regression analysis.Results The overall median survival time was 10 months (95% CI9.06--10.94) and the 1,3,5 year survival rates were 7.46%,1.14% and 0,respectively.In the univariate model,none of the following variables had effect on survival age,gender,T stage of the tumor,nodal status,number of extra cranial metastases and histological type.Univariate analysis showed a better survival for the combination of surgical resection,chemotherapy and radiation (P=0.00).Based on Cox-regression analysis,treatment modality was the only independent predictor of survival Conclusions Aggressive combined therapy of brain metastases may achieve a survival advantage.Excellent overall survival of lung cancer with brain metastases has been achieved with a combination of WBRT with surgical resection and chemotherapy.