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Brain metastasis from non-small cell lung cancer (NSCLC)

Prognostic importance of the number of involved extracranial organs

Hirnmetastasen beim nicht-kleinzelligen Lungenkarzinom (NSCLC)

Prognostische Bedeutung der Anzahl befallener extrakranieller Organe

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Abstract

Background and purpose

This study investigated the potential prognostic value of the number of involved extracranial organs in patients with brain metastasis from non-small cell lung cancer (NSCLC).

Material and methods

A total of 472 patients who received whole-brain radiotherapy (WBRT) alone with 5 × 4 Gy or 10 × 3 Gy for brain metastasis from NSCLC were included in this retrospective study. In addition to the number of involved extracranial organs, 6 further potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), number of brain metastases, and the interval from cancer diagnosis to WBRT. Subgroup analyses were performed for patients with metastatic involvement of one (lung vs. bone vs. other metastasis) and two (lung + bone vs. lung + lymph nodes vs. other combinations) extracranial organs.

Results

The survival rates at 6 months of the patients with involvement of 0, 1, 2, 3, and ≥ 4 extracranial organs were 52, 27, 17, 4, and 14 %, respectively (p < 0.001). On multivariate analysis, the number of involved extracranial organs remained significant (risk ratio 1.32; 95 % confidence interval 1.19–1.46; p < 0.001). Age < 65 years (p = 0.004), KPS ≥ 70 (p < 0.001), and only 1–3 brain metastases (p = 0.022) were also significantly associated with survival in the multivariate analysis. In the separate analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the pattern of extracranial organ involvement.

Conclusion

The number of involved extracranial organs is an independent prognostic factor of survival in patients with brain metastasis from NSCLC, irrespective of the pattern of extracranial organ involvement.

Zusammenfassung

Hintergrund und Ziel

In dieser Studie wurde die prognostische Bedeutung der Anzahl der befallenen extrakraniellen Organe für das Überleben von Patienten mit Hirnmetastasen eines nicht-kleinzelligen Bronchialkarzinoms (NSCLC) untersucht.

Material und Methoden

Insgesamt wurden 472 Patienten, die eine alleinige Ganzhirnbestrahlung (WBRT) mit 5 × 4 Gy oder 10 × 3 Gy bei Hirnmetastasen eines NSCLC erhalten hatten, in diese retrospektive Studie eingeschlossen. Zusätzlich zu der Anzahl befallener extrakranieller Organe wurden 6 weitere mögliche Prognosefaktoren untersucht: WBRT-Regime, Alter, Geschlecht, Karnofsky-Performance-Score (KPS), Anzahl der Hirnmetastasen und das Intervall von der Erstdiagnose der Tumorerkrankung bis zur WBRT. Subgruppenanalysen erfolgten für Patienten mit Befall von einem (Lunge vs. Knochen vs. andere) oder zwei (Lunge + Knochen vs. Lunge + Lymphknoten vs. andere Kombinationen) extrakraniellen Organen.

Ergebnisse

Die Überlebensraten nach 6 Monaten bei Befall von 0, 1, 2, 3 und ≥ 4 extrakraniellen Organen betrugen jeweils 52, 27, 17, 4 und 14 % (p < 0,001). In der multivariaten Analyse blieb die Anzahl der befallenen extrakraniellen Organe signifikant (Risk Ratio 1,32; 95 %-Konfidenzintervall 1,19–1,46; p < 0,001). Ein Alter < 65 Jahre (p = 0,004), ein KPS ≥ 70 (p < 0,001) und das Vorliegen von nur 1–3 Hirnmetastasen (p = 0,022) waren in der multivariaten Analyse ebenfalls signifikant mit dem Überleben assoziiert. In den separaten Analysen der Patienten mit Befall von einem oder zwei extrakraniellen Organen war das Überleben nicht signifikant mit der Art des befallenen Organs/der befallenen Organe assoziiert.

Schlussfolgerung

Die Anzahl der befallenen extrakraniellen Organe ist ein unabhängiger Prognosefaktor für das Überleben bei Patienten mit Hirnmetastasen eines NSCLC, unabhängig von der Art der befallenen Organe.

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Compliance with ethical guidelines

Conflict of interest. L. Gerdan, B. Segedin, V. Nagy, M.T. Khoa, N.T. Trang, S.E. Schild, and D. Rades state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals

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Correspondence to D. Rades M.D..

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Gerdan, L., Segedin, B., Nagy, V. et al. Brain metastasis from non-small cell lung cancer (NSCLC). Strahlenther Onkol 190, 64–67 (2014). https://doi.org/10.1007/s00066-013-0439-6

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  • DOI: https://doi.org/10.1007/s00066-013-0439-6

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