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Predictors for patterns of brain relapse and overall survival in patients with non-small cell lung cancer

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Abstract

Our goal was to investigate prognostic factors for different patterns of brain relapse and overall survival so that treatments could be tailored and treatment outcomes improved. We studied 292 patients with non-small cell lung cancer (NSCLC) who had symptomatic, solitary, or multiple brain metastases (isolated or not isolated from extracranial metastases) that had developed early (≦6 months) or late (>6 months) from initial diagnosis. Factors affecting patterns of relapse and survival were analyzed by univariate and multivariate analyses. Good ECOG performance status (PS) at the time of NSCLC diagnosis was the most important factor that predicted late (rather than early) relapse and improved survival, and was the only factor that predicted isolated brain metastases. Patients whose lungs showed a complete response (CR) to treatment had a higher rate of late brain relapses than non-responders (NR) did (67.3% vs. 7.8%, P < 0.001). CR patients also experienced a longer median overall survival than NR patients. Patients with late brain relapses showed better median survival times (18 months vs. 4 months, P < 0.0001) than patients with early relapses, and this was an independent factor by Cox regression analysis. Our findings provide a justification for enrolling patients with good PS and controlled lung lesions into clinical trials for the prevention of early, non-isolated brain relapse. More aggressive therapeutic approaches should be applied to patients with late, isolated and solitary relapses to improve both quality and quantity of life.

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Authors and Affiliations

  1. Department of Radiation Oncology, Chang Gung Memorial Hospital, #5, Fu-Shin St., Tao-Yuan County, Kwei-Shan, Taiwan

    Simon Guo-Jeng Tang, Chen-Kan Tseng, Ping-Chin Pai & Ji-Hong Hong

  2. Department of public Health, Chang Gung University College of Medicine, Tao-Yuan County

    Pei-Kwei Tsay

  3. Department of Thoracic Medicine, Taiwan

    Chih-Hung Chen

  4. Department to Medical Oncology, Chang Gung Memorial Hospital, Tao-Yuan County, Taiwan

    John Wen-Cheng Chang

Authors
  1. Simon Guo-Jeng Tang
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  2. Chen-Kan Tseng
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Correspondence to Simon Guo-Jeng Tang.

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Tang, S.GJ., Tseng, CK., Tsay, PK. et al. Predictors for patterns of brain relapse and overall survival in patients with non-small cell lung cancer. J Neurooncol 73, 153–161 (2005). https://doi.org/10.1007/s11060-004-3725-4

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