Clinical Outcomes of Surgical Resection for Brain Metastases from Non-small Cell Lung Cancer
Clinical Outcomes of Surgical Resection for Brain Metastases from Non-small Cell Lung Cancer
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DOI：
10.21873/anticanres.14483
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发表时间：
2020-08-01
影响因子：
2
通讯作者：
Fujita, Mitsugu
中科院分区：
文献类型：
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作者：
Nakao, Takayuki;Okuda, Takeshi;Fujita, Mitsugu
背景/目的：全身化疗的最新进展，包括分子靶向治疗，极大地提高了晚期非小细胞肺癌患者的生存率。我们回顾性分析了在日本大坂的Kindai大学医院神经外科手术切除非小细胞肺癌脑转移的临床结果。患者和方法：对56例非小细胞肺癌脑转移患者进行了开颅手术和肿瘤切除术。腺癌是最常见的组织学类型，出现在40例病例中，其中18例为驱动基因突变阳性。结果如下：所有56例患者的中位生存期为14.5个月，单发脑转移和腺癌被确定为有利的预后因素。仅限于40例腺癌的分析确定单一脑转移是一个有利的预后因素。虽然全身化疗无显著差异，但接受分子靶向治疗的患者比接受细胞毒化疗的患者预后更好。对整个组和单独腺癌患者的分析发现，全脑放疗与生存率没有显着相关性。结论：单发脑转移瘤和腺癌被认为是有利的预后因素，但没有证实全脑放疗有任何益处。这些结果表明，多模式治疗策略利用各种治疗方法，包括全身化疗，可能有助于延长患者的生存在未来。
Background/Aim: Recent advances in systemic chemotherapy, including molecularly targeted therapy, have dramatically improved survival for patients with advanced non-small cell lung cancer. We retrospectively analyzed the clinical outcomes of surgical resection for brain metastases of nonsmall cell lung cancer cases performed at the Department of Neurosurgery of Kindai University Hospital, Osaka, Japan. Patients and Methods: Craniotomy and tumor resection were performed for 56 patients with brain metastases of non-small cell lung cancer. Adenocarcinoma was the most common histological type, appearing in 40 cases, of which 18 were positive for driver gene mutations. Results: Median survival for all 56 patients was 14.5 months, and single brain metastasis and adenocarcinoma were identified as favorable prognostic factors. Analysis limited to the 40 cases of adenocarcinoma identified single brain metastasis as a favorable prognostic factor. Although no significant difference was found for systemic chemotherapy, patients who received molecularly targeted therapy showed a better prognosis than those who received cytotoxic chemotherapy. Analyses of both the entire group and of adenocarcinoma patients alone found that whole-brain radiotherapy showed no significant association with survival. Conclusion: Single brain metastasis and adenocarcinoma were identified as favorable prognostic factors, but did not confirm any benefit from whole-brain radiotherapy. These results suggest that multimodal treatment strategies utilizing various methods of treatment, including systemic chemotherapy, may help prolong patient survival in the future.