Non-small cell lung cancer with synchronous brain metastases: Identification of prognostic factors in a retrospective multicenter study (HOT 1701).

IF 3.7 Q1 CLINICAL NEUROLOGY Neuro-oncology advances Pub Date : 2024-10-05 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae168

Yoshihito Ohhara, Tetsuya Kojima, Osamu Honjo, Noriyuki Yamada, Toshitaka Sato, Hirofumi Takahashi, Kei Takamura, Taichi Takashina, Noriaki Sukoh, Hisashi Tanaka, Yasutaka Kawai, Yuka Fujita, Keiki Yokoo, Fumihiro Hommura, Toshiyuki Harada, Ryoichi Honda, Toraji Amano, Hirotoshi Dosaka-Akita, Satoshi Oizumi, Ichiro Kinoshita

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Abstract

Background: Non-small-cell lung cancer (NSCLC) is associated with a high incidence of brain metastasis (BM), and the prognosis of patients with NSCLC and BM is poor. This study aimed to identify the prognostic factors and elucidate the survival rates of Japanese patients with NSCLC and BM at initial diagnosis.

Methods: HOT 1701 is a retrospective multicenter study of patients with NSCLC and BM at initial diagnosis. The medical records of all consecutive patients diagnosed with advanced or recurrent NSCLC and BM at 14 institutions of the Hokkaido Lung Cancer Clinical Study Group Trial (HOT) in Japan were reviewed. The participants were categorized based on the presence or absence of driver mutations. The Kaplan-Meier method was used to estimate median overall survival (OS). Univariate and multivariate analyses were performed to identify prognostic factors in these patients.

Results: Among 566 patients with NSCLC and BM, the median OS was 11.8 months. Patients with driver mutations survived longer than those without driver mutations. The univariate and multivariate analyses revealed 6 independent prognostic factors: age ≥65 years, poor performance status, T factor, absence of driver gene mutations, presence of extracranial metastases, and number of BM. According to the prognostic score based on these 6 factors, the patients were stratified into 3 risk groups: low-, intermediate-, and high-risk, with median OS of 27.8, 12.2, and 2.8 months, respectively.

Conclusions: We developed a new prognostic model for patients with NSCLC and BM, which may help determine prognosis at diagnosis.

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非小细胞肺癌同步脑转移：一项多中心回顾性研究（HOT 1701）的预后因素鉴定。

背景：非小细胞肺癌（NSCLC）与脑转移（BM）的高发病率有关，NSCLC合并BM患者的预后较差。本研究旨在确定日本 NSCLC 患者的预后因素，并阐明初诊时 NSCLC 和 BM 患者的生存率。研究人员查阅了日本北海道肺癌临床研究小组试验（HOT）的 14 家机构中所有连续确诊为晚期或复发性 NSCLC 和 BM 患者的病历。根据是否存在驱动基因突变对参与者进行了分类。采用卡普兰-梅耶法估算中位总生存期（OS）。进行单变量和多变量分析以确定这些患者的预后因素：在566例NSCLC和BM患者中，中位生存期为11.8个月。有驱动基因突变的患者比没有驱动基因突变的患者存活时间更长。单变量和多变量分析显示了6个独立的预后因素：年龄≥65岁、表现状况不佳、T因子、无驱动基因突变、存在颅外转移灶和BM数量。根据基于这6个因素的预后评分，患者被分为3个风险组：低风险、中风险和高风险，中位OS分别为27.8个月、12.2个月和2.8个月：我们为NSCLC和BM患者建立了一个新的预后模型，这可能有助于在诊断时确定预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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