Survival Benefits of Radiotherapy and Surgery in Lung Cancer Brain Metastases with Poor Prognosis Factors

被引：1

作者：

Liang, Lun ^{[1
]}

Wang, Zhenning ^{[1
,2
]}

Duan, Hao ^{[1
]}

He, Zhenqiang ^{[1
]}

Lu, Jie ^{[1
]}

Jiang, Xiaobing ^{[1
]}

Hu, Hongrong ^{[1
]}

Li, Chang ^{[1
]}

Yu, Chengwei ^{[1
]}

Zhong, Sheng ^{[1
]}

Cui, Run ^{[1
]}

Guo, Xiaoyu ^{[3
]}

Deng, Meiling ^{[4
]}

Chen, Yuanyuan ^{[4
]}

Du, Xiaojing ^{[4
]}

Wu, Shaoxiong ^{[4
]}

Chen, Likun ^{[5
]}

Mou, Yonggao ^{[1
]}

机构：

[1] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, Dept Neurosurg, State Key Lab Oncol South China,Canc Ctr, Guangzhou 510060, Peoples R China

[2] South Med Univ, Dongguan Peoples Hosp, Affiliated Dongguan Hosp, Dept Neurosurg, Dongguan 523058, Peoples R China

[3] Jinan Univ, Affiliated Hosp 1, Dept Neurosurg, Guangzhou 518053, Peoples R China

[4] Sun Yat sen Univ, Collaborat Innovat Ctr Canc Med, Dept Radiotherapy, State Key Lab Oncol South China,Canc Ctr, Guangzhou 510060, Peoples R China

[5] Sun Yat sen Univ, Collaborat Innovat Ctr Canc Med, Dept Med Oncol, State Key Lab Oncol South China,Canc Ctr, Guangzhou 510060, Peoples R China

来源：

CURRENT ONCOLOGY | 2023年 / 30卷 / 02期

基金：

中国国家自然科学基金;

关键词：

surgery; radiotherapy; poor prognosis; lung cancer brain metastases; STEREOTACTIC RADIOSURGERY; SINGLE METASTASES; RADIATION-THERAPY; ELDERLY-PATIENTS; PHASE-3; RESECTION;

D O I：

10.3390/curroncol30020172

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Radiotherapy and surgery are the standard local treatments for lung cancer brain metastases (BMs). However, limited studies focused on the effects of radiotherapy and surgery in lung cancer BMs with poor prognosis factors. Methods: We retrospectively analyzed 714 patients with lung cancer BMs. Analyses of overall survival (OS) and risk factors for OS were assessed by the log-rank test and Cox proportional hazard model. Results: Age >= 65 years, a Karnofsky Performance Scale (KPS) score <= 70, anaplastic large-cell lymphoma kinase (ALK)/epidermal growth factor receptor (EGFR) wild type, and extracranial metastases were related to poor prognosis. Patients were stratified according to these poor prognosis factors. In patients with the ALK/EGFR wild type, whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), and surgery improved the OS of patients. WBRT and SRS were the independent protective factors for OS. In patients with extracranial metastases, patients who received WBRT plus SRS or WBRT alone had longer OS than those who did not receive radiotherapy. WBRT plus SRS and WBRT were the independent protective factors for OS. Conclusions: Radiotherapy and surgery are associated with improved survival for lung cancer BMs with the ALK/EGFR wild type. Radiotherapy is associated with improved survival in lung cancer BMs with extracranial metastases.

引用

页码：2227 / 2236

页数：10

共 24 条

[1] Brain metastases [J].

Achrol, Achal Singh ;

Rennert, Robert C. ;

Anders, Carey ;

Soffietti, Riccardo ;

Ahluwalia, Manmeet S. ;

Nayak, Lakshmi ;

Peters, Solange ;

Arvold, Nils D. ;

Harsh, Griffith R. ;

Steeg, Patricia S. ;

Chang, Steven D. .

NATURE REVIEWS DISEASE PRIMERS, 2019, 5 (1)

[2] Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases - A randomized controlled trial [J].

Aoyama, Hidefumi ;

Shirato, Hiroki ;

Tago, Masao ;

Nakagawa, Keiichi ;

Toyoda, Tatsuya ;

Hatano, Kazuo ;

Kenjyo, Masahiro ;

Oya, Natsuo ;

Hirota, Saeko ;

Shioura, Hiroki ;

Kunieda, Etsuo ;

Inomata, Taisuke ;

Hayakawa, Kazushige ;

Katoh, Norio ;

Kobashi, Gen .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 295 (21) :2483-2491

[3] Effect of Radiosurgery Alone vs Radiosurgery With Whole Brain Radiation Therapy on Cognitive Function in Patients With 1 to 3 Brain Metastases A Randomized Clinical Trial [J].

Brown, Paul D. ;

Jaeckle, Kurt ;

Ballman, Karla V. ;

Farace, Elana ;

Cerhan, Jane H. ;

Anderson, S. Keith ;

Carrero, Xiomara W. ;

Barker, Fred G., II ;

Deming, Richard ;

Burri, Stuart H. ;

Menard, Cynthia ;

Chung, Caroline ;

Stieber, Volker W. ;

Pollock, Bruce E. ;

Galanis, Evanthia ;

Buckner, Jan C. ;

Asher, Anthony L. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 316 (04) :401-409

[4] Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial [J].

Chang, Eric L. ;

Wefel, Jeffrey S. ;

Hess, Kenneth R. ;

Allen, Pamela K. ;

Lang, Frederick F. ;

Kornguth, David G. ;

Arbuckle, Rebecca B. ;

Swint, J. Michael ;

Shiu, Almon S. ;

Maor, Moshe H. ;

Meyers, Christina A. .

LANCET ONCOLOGY, 2009, 10 (11) :1037-1044

[5] Use of Stereotactic Radiosurgery in Elderly and Very Elderly Patients With Brain Metastases to Limit Toxicity Associated With Whole Brain Radiation Therapy [J].

Chen, Linda ;

Shen, Colette ;

Redmond, Kristin J. ;

Page, Brandi R. ;

Kummerlowe, Megan ;

Mcnutt, Todd ;

Bettegowda, Chetan ;

Rigamonti, Daniele ;

Lim, Michael ;

Kleinberg, Lawrence .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2017, 98 (04) :939-947

[6] Long-Term Survivorship Following Stereotactic Radiosurgery Alone for Brain Metastases: Risk of Intracranial Failure and Implications for Surveillance and Counseling [J].

Gogineni, Emile ;

Vargo, John A. ;

Glaser, Scott M. ;

Flickinger, John C. ;

Burton, Steven A. ;

Engh, Johnathan A. ;

Amankulor, Nduka M. ;

Beriwal, Sushil ;

Quinn, Anette E. ;

Ozhasoglu, Cihat ;

Heron, Dwight E. .

NEUROSURGERY, 2018, 83 (02) :203-209

[7] Lung Cancer Brain Metastases [J].

Goldberg, Sarah B. ;

Contessa, Joseph N. ;

Omay, Sacit B. ;

Chiang, Veronica .

CANCER JOURNAL, 2015, 21 (05) :398-403

[8] Stereotactic radiosurgery in elderly patients with brain metastases: comparison with non-elderly patients using database of a multi-institutional prospective observational study (JLGK0901-Elderly) [J].

Higuchi, Yoshinori ;

Yamamoto, Masaaki ;

Serizawa, Toru ;

Sato, Yasunori ;

Shuto, Takashi ;

Akabane, Atsuya ;

Jokura, Hidefumi ;

Yomo, Shoji ;

Nagano, Osamu ;

Kawagishi, Jun ;

Yamanaka, Kazuhiro ;

Aoyama, Hidefumi .

JOURNAL OF NEURO-ONCOLOGY, 2019, 144 (02) :393-402

[9] Adjuvant Whole-Brain Radiotherapy Versus Observation After Radiosurgery or Surgical Resection of One to Three Cerebral Metastases: Results of the EORTC 22952-26001 Study [J].

Kocher, Martin ;

Soffietti, Riccardo ;

Abacioglu, Ufuk ;

Villa, Salvador ;

Fauchon, Francois ;

Baumert, Brigitta G. ;

Fariselli, Laura ;

Tzuk-Shina, Tzahala ;

Kortmann, Rolf-Dieter ;

Carrie, Christian ;

Ben Hassel, Mohamed ;

Kouri, Mauri ;

Valeinis, Egils ;

van den Berge, Dirk ;

Collette, Sandra ;

Collette, Laurence ;

Mueller, Rolf-Peter .

JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (02) :134-141

[10] Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial [J].

Mahajan, Anita ;

Ahmed, Salmaan ;

McAleer, Mary Frances ;

Weinberg, Jeffrey S. ;

Li, Jing ;

Brown, Paul D. ;

Settle, Stephen ;

Prabhu, Sujit S. ;

Lang, Frederick F. ;

Levine, Nicholas ;

McGovern, Susan ;

Sulman, Erik ;

McCutcheon, Ian E. ;

Azeem, Syed ;

Cahill, Daniel ;

Tatsui, Claudio ;

Heimberger, Amy B. ;

Ferguson, Sherise ;

Ghia, Amol ;

Demonte, Franco ;

Raza, Shaan ;

Guha-Thakurta, Nandita ;

Yang, James ;

Sawaya, Raymond ;

Hess, Kenneth R. ;

Rao, Ganesh .

LANCET ONCOLOGY, 2017, 18 (08) :1040-1048

← 1 2 3 →