Treatment and prognostic analysis of patients with leptomeningeal metastases from non-small cell lung cancer.
BACKGROUND
Leptomeningeal metastases (LM) from non-small cell lung cancer (NSCLC) are associated with poor prognosis and optimal treatment for this subgroup of NSCLC patients is controversial. The purpose of this study is to evaluate treatment options and prognostic factors of NSCLC patients with LM.


METHODS
We retrospectively analyzed data of 108 patients who had been diagnosed with LM from NSCLC between May 2006 and August 2013.


RESULTS
The median survival time (MST) of the 108 patients was 5.3 months, and the one-year survival rate was 23.7%. Forty-nine patients received whole brain radiotherapy (WBRT) and the MST of patients who received WBRT and those who did not were 6.4 and 4.3 months, respectively. Forty-two patients were treated with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) after being diagnosed with LM. These patients had prolonged survival (11.1 vs. 4.4 months). Patients who received concomitant WBRT and EGFR-TKIs had the longest MST (12.3 months). Eastern Cooperative Oncology Group performance status, whether patients received WBRT, and/or EGFR-TKIs were independent prognostic factors for patients with LM from NSCLC.


CONCLUSIONS
WBRT, EGFR-TKIs or combined therapy, could lead to better clinical outcomes for NSCLC patients with LM. EGFR-TKIs plus WBRT has the potential to be the standard strategy for LM in NSCLC patients.
Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Soochow University Suzhou, China ; Department of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University Shanghai, China.
Qinghua
Q
Xu
Department of Respiratory, Zaozhuang Municipal Hospital Zaozhuang, China.
Xiu
X
Chen
Department of Respiratory, Nanjing Red Cross Hospital Nanjing, China.
Danwen
D
Qian
Department of Respiratory Medicine, Drum Tower Hospital, Medical School of Nanjing University Nanjing, China.
Yongsheng
Y
Wang
Department of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University Shanghai, China.
Shuyan
S
Meng
Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Soochow University Suzhou, China.
Hui
H
Liu
Department of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Soochow University Suzhou, China ; Department of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University Shanghai, China.
Caicun
C
Zhou
EGFR-TKIs; WBRT; leptomeningeal metastases; non- small cell lung cancer; prognostic factors