基于增强MRI诊断并行全脑放疗的非小细胞肺癌脑转移预后分析

BACKGROUND AND OBJECTIVE: Brain metastases are a common complication of lung cancer, occurring in 20%-40% of patients. The aim of this study is to explore prognostic factors in non-small cell lung cancer (NSCLC) in patients with brain metastases diagnosed by constrast-enhanced MRI after whole brain radiotherapy. METHODS: TA retrospective review of clinical data from 241 NSCLC patients with brain metastases received whole brain radiotherapy from April 2007 to October 2008 was performed. A number of potential factors that might affect prognosis after irradiation were evaluated. The significance of prognostic variables in the survival resulted from univariate analysis by Kaplan-Meier combining with Log-rank test, and the multivariate analysis was obtained by Cox regression model. RESULTS: Median follow-up time for the survivors was 19.1 months. For all patients, the median survival time (MST) was 8.7 months. By univariate analysis, female patients with KPS > 70, no symptom when diagnosed with brain metastases, tumor controlled in the chest, and received more than 3 cycles of chemotherapy and combined target therapy were the important factors for overall survival. By multivariate analysis, female, tumors controlled in the chest, and combined target therapy were independent prognostic factors for NSCLC patients with brain metastases. Tumor controlled in the chest was the most important independent prognostic factor. CONCLUSION: Gender, local tumor controlled, and combined target therapy significantly influenced NSCLC brain metastases diagnosed by constrast-enchanced MRI survival after whole brain radiotherapy.