Risk of cerebral metastases for postoperative locally advanced non-small-cell lung cancer.
BACKGROUND
Cerebral metastases are the main determining factor in the failure of locally advanced non-small-cell lung cancer (NSCLC) management. Our study assessed the risk factors of brain metastases in patients with postoperative, locally advanced NSCLC. Implications for PCI treatment are discussed.


METHODS
Two hundred twenty-three patients treated with surgical resection for stage III-N2 NSCLC were retrospective analyzed to elucidate risk factors for development of brain metastases, and to establish a mathematical model.


RESULTS
Median survival time for this patient population was 29.5 months. Frequency of brain metastases in the entire patient population was 38.1% (85/223). Frequency of brain metastases in patients with single mediastinal lymph-node region with metastases at 1, 2, and 3 years was 5.6%, 14.0%, and 19.0%, respectively. The frequency of brain metastases in patients with multiple mediastinal lymph-node regions with metastases was 31.8%, 60.3%, 68.0%, respectively (P<0.001). The frequency of brain metastases among patients with mediastinal metastasis number less than 4, 4-6, and more than 6 was significantly different (P<0.001). There were also significant differences in brain metastases frequency between patients with complete versus incomplete resection (P=0.001), and patients with non-squmous versus squamous (P=0.029), and patients administered adjuvant chemotherapy versus none (P=0.032).


CONCLUSIONS
A mathematical model to predict brain metastases risk was developed. It can aid in selection of patients with locally advanced NSCLC for PCI in clinical trails.
Cancer Center of Sun Yat-sen University, Guangzhou, PR China. wsysums@163.net
Si-Yu
SY
Wang
Xiong
X
Ye
Wei
W
Ou
Yong-Bin
YB
Lin
Bin-Bin
BB
Zhang
Hua
H
Yang
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
D000970:Antineoplastic Agents