[Prognostic predictors for non-small cell lung cancer patients with brain metastasis after radiotherapy.].
BACKGROUND
Brain metastasis (BM) is often found in the patients with lung cancer. Radiotherapy is regular and effective means of therapy and it aims at palliating symptoms and prolonging survival time. However, now there are different viewpoints on protocols of radiotherapy and prognostic factors. A retrospective analysis is used to evaluate the results of treatment for 82 cases with brain metastasis from non-small cell lung cancer (NSCLC) and explore the prognostic factors to establish a prognostic index (PI) model.


METHODS
From Feb.1995 to Oct. 2006, 82 patients irradiated for BM from NSCLC, with both complete medical charts and follow-up data available, were eligible for this retrospective analysis. A number of potential factors which might affect prognosis after irradiation were evaluated. The significance of prognostic variables in the survival resulted from both univariate analysis by Kaplan-Meier combining with log-rank test and multivariate Cox regression model. The prognostic index (PI) was established based on Cox regression analysis and subgrouping values.


RESULTS
The follow-up time was 1-120 months. For the entire cohort, the median survival from the start of radiation for BM was 10.5 months, and the actuarial overall survival rate was 50.8%, 23.7% and 5.1% at 0.5, 1 and 2 years respectively. Univariate analysis showed KPS, control of primary tumor, interval from the beginning of diagnostic to BM, extracranial systemic metastasis, counts of lymphocyte and solitary BM were predictors of prognosis. However, in the Cox multivariate analysis, only KPS, control of primary tumor, interval from the beginning of diagnostic to BM and solitary BM were significant prognostic factors. The prognostic index was established based on Cox regression analysis and 82 patients were stratified good, intermediate and poor prognostic sub-groups. The difference of survival rate among 3 subgroups is significant (P <0.001).


CONCLUSIONS
Radiotherapy is proved to be effective for NSCLC patients with BM. KPS, control of primary tumor, interval from the beginning of diagnostic to BM and solitary BM are independent prognostic factors. PI model can well predict the prognostic of patients with BM from NSCLC.
Fan
Qiuhong
Q
Department of Radiation Oncology, Second Hospital Affiliated to Suzhou University, Suzhou, Jiangsu 215004, China.
Sun
Chunhua
C
Tian
Ye
Y