Survival of patients with non-small-cell lung cancer after a diagnosis of brain metastases
Survival of patients with non-small-cell lung cancer after a diagnosis of brain metastases
复制标题
DOI：
10.3747/co.20.1481
复制
发表时间：
2013-08-01
期刊：
影响因子：
2.6
通讯作者：
Ellis, P. M.
中科院分区：
文献类型：
--
作者：
Ali, A.;Goffin, J. R.;Ellis, P. M.
背景：非小细胞肺癌（NSCLC）脑转移患者预后较差。然而，一些报道表明，在初始诊断时脑转移的患者比无脑转移的晚期NSCLC患者有更有利的生存。方法对2005年7月至2007年6月在加拿大某三级医疗中心就诊的所有新发肺癌患者进行回顾性队列研究，对初诊断为脑转移的患者和晚期发生脑转移的患者进行脑转移诊断后的生存率检查。结果2年期间，878例患者中有91例（10.4%）发生脑转移。该队列的中位年龄为64岁。其中45例在最初诊断时出现脑转移，46例在病程后期出现脑转移。整个队列的中位生存期为7.8个月。脑转移患者在诊断时和疾病后期的生存期相似（4.8个月vs 3.7个月，p = 0.53）。因此，晚期发生脑转移的患者比诊断时发生脑转移的患者的总生存期更长（9.8个月对4.8个月）。在接受化疗的患者中，脑转移患者在诊断时的生存期仍然很差（6.2个月）。研究数据显示，非小细胞肺癌脑转移患者的生存期有限。谨慎的病人选择更积极的治疗方法是必要的。
BackgroundThe prognosis of patients with brain metastases from non-small-cell lung cancer (NSCLC) is poor. However, some reports suggest that patients with brain metastases at the time of initial diagnosis have a more favourable survival than do patients with advanced NSCLC without brain metastases.MethodsIn a retrospective cohort of all new lung cancer patients seen at a Canadian tertiary centre between July 2005 and June 2007, we examined survival after a diagnosis of brain metastases for patients with brain metastases at initial diagnosis and patients who developed brain metastases later in their illness.ResultsDuring the 2-year period, 91 of 878 patients (10.4%) developed brain metastases. Median age in this cohort was 64 years. In 45, brain metastases were present at initial diagnosis, and in 46, brain metastases developed later in the course of the illness. Median survival in the entire cohort was 7.8 months. Survival after the diagnosis of brain metastases was similar for patients with brain metastases at diagnosis and later in the illness (4.8 months vs. 3.7 months, p = 0.53). As a result, patients who developed brain metastases later in their illness had a longer overall survival than did patients with brain metastases at diagnosis (9.8 months vs. 4.8 months). Among patients who received chemotherapy, the survival of patients with brain metastases at diagnosis was still poor (6.2 months).ConclusionsOur data show limited survival in patients with brain metastases from NSCLC. Careful patient selection for more aggressive treatment approaches is necessary.