T. Duell , S. Kappler , B. Knöferl , T. Schuster , J. Hochhaus , A. Morresi-Hauf , RM. Huber , A. Tufman , V. Zietemann
{"title":"新诊断晚期非小细胞肺癌患者脑转移的患病率及危险因素","authors":"T. Duell , S. Kappler , B. Knöferl , T. Schuster , J. Hochhaus , A. Morresi-Hauf , RM. Huber , A. Tufman , V. Zietemann","doi":"10.1016/j.ctrc.2015.08.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Micro-abstract</h3><p>Brain metastases are a frequent finding in patients with advanced non-small cell lung cancer (NSCLC). The characteristics of 118 patients with synchronous brain metastases (BM) out of a cohort of 678 individuals with advanced NSCLC (17%) are reported, with synchronous BM having a negative impact on survival. Prognostic factors for survival of the patients with and without BM are presented.</p></div><div><h3>Background</h3><p>Brain metastases occur frequently in patients with newly diagnosed non-small cell lung cancer. We aim to describe the characteristics, treatment and course of disease in patients with synchronous BM in an advanced NSCLC cohort, and to comparatively analyze prognostic factors for patients with and without BM.</p></div><div><h3>Patients and methods</h3><p>Of 678 consecutive unselected patients with stage IV NSCLC, 118 presented with synchronous BM (17%; 95% confidence interval [CI]: 15–20%). The patient characteristics, prognostic factors, therapeutic approach and use of specific therapeutic measures including systemic treatment were analyzed.</p></div><div><h3>Results</h3><p>BM were found more frequently in younger patients, females, non-smokers and those with a lower thoracic stage. 29% of patients with BM exhibited neurologic symptoms. Patients with BM showed worse overall survival (median survival 8.0 vs 9.7 months; HR 1.24 [1.05–1.54]; <em>p</em>=0.045). In multivariable analysis poor performance status at diagnosis showed the strongest negative association with survival.</p></div><div><h3>Conclusion</h3><p>Synchronous BM are frequent among patients with NSCLC even in early thoracic stages and negatively impact survival. Based on the findings presented in this paper, a therapy algorithm for treating BM is proposed, with systemic therapy being one valuable option.</p></div>","PeriodicalId":90461,"journal":{"name":"Cancer treatment communications","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ctrc.2015.08.004","citationCount":"9","resultStr":"{\"title\":\"Prevalence and risk factors of brain metastases in patients with newly diagnosed advanced non-small-cell lung cancer\",\"authors\":\"T. Duell , S. Kappler , B. Knöferl , T. Schuster , J. Hochhaus , A. Morresi-Hauf , RM. Huber , A. Tufman , V. Zietemann\",\"doi\":\"10.1016/j.ctrc.2015.08.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Micro-abstract</h3><p>Brain metastases are a frequent finding in patients with advanced non-small cell lung cancer (NSCLC). The characteristics of 118 patients with synchronous brain metastases (BM) out of a cohort of 678 individuals with advanced NSCLC (17%) are reported, with synchronous BM having a negative impact on survival. Prognostic factors for survival of the patients with and without BM are presented.</p></div><div><h3>Background</h3><p>Brain metastases occur frequently in patients with newly diagnosed non-small cell lung cancer. We aim to describe the characteristics, treatment and course of disease in patients with synchronous BM in an advanced NSCLC cohort, and to comparatively analyze prognostic factors for patients with and without BM.</p></div><div><h3>Patients and methods</h3><p>Of 678 consecutive unselected patients with stage IV NSCLC, 118 presented with synchronous BM (17%; 95% confidence interval [CI]: 15–20%). The patient characteristics, prognostic factors, therapeutic approach and use of specific therapeutic measures including systemic treatment were analyzed.</p></div><div><h3>Results</h3><p>BM were found more frequently in younger patients, females, non-smokers and those with a lower thoracic stage. 29% of patients with BM exhibited neurologic symptoms. Patients with BM showed worse overall survival (median survival 8.0 vs 9.7 months; HR 1.24 [1.05–1.54]; <em>p</em>=0.045). In multivariable analysis poor performance status at diagnosis showed the strongest negative association with survival.</p></div><div><h3>Conclusion</h3><p>Synchronous BM are frequent among patients with NSCLC even in early thoracic stages and negatively impact survival. Based on the findings presented in this paper, a therapy algorithm for treating BM is proposed, with systemic therapy being one valuable option.</p></div>\",\"PeriodicalId\":90461,\"journal\":{\"name\":\"Cancer treatment communications\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ctrc.2015.08.004\",\"citationCount\":\"9\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer treatment communications\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213089615300098\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer treatment communications","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213089615300098","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 9
摘要
脑转移是晚期非小细胞肺癌(NSCLC)患者的常见发现。报告了678例晚期NSCLC患者(17%)中118例同步脑转移(BM)患者的特征,同步脑转移对生存有负面影响。提出了有和没有BM患者生存的预后因素。背景:脑转移经常发生在新诊断的非小细胞肺癌患者中。我们的目的是描述晚期NSCLC队列中同步脑转移患者的特征、治疗和病程,并比较分析有和没有脑转移患者的预后因素。患者和方法在678例连续未选择的IV期NSCLC患者中,118例出现同步脑转移(17%;95%置信区间[CI]: 15-20%)。分析了患者的特点、预后因素、治疗方法和包括全身治疗在内的特殊治疗措施的使用情况。结果年轻患者、女性、非吸烟者及胸段较低者多见。29%的BM患者表现出神经系统症状。BM患者的总生存期较差(中位生存期8.0 vs 9.7个月;Hr 1.24 [1.05-1.54];p = 0.045)。在多变量分析中,诊断时的不良表现与生存率呈最强负相关。结论同步脑转移在非小细胞肺癌患者中很常见,即使是在胸部早期,也会对生存率产生负面影响。基于本文的研究结果,提出了一种治疗BM的治疗算法,其中全身治疗是一种有价值的选择。
Prevalence and risk factors of brain metastases in patients with newly diagnosed advanced non-small-cell lung cancer
Micro-abstract
Brain metastases are a frequent finding in patients with advanced non-small cell lung cancer (NSCLC). The characteristics of 118 patients with synchronous brain metastases (BM) out of a cohort of 678 individuals with advanced NSCLC (17%) are reported, with synchronous BM having a negative impact on survival. Prognostic factors for survival of the patients with and without BM are presented.
Background
Brain metastases occur frequently in patients with newly diagnosed non-small cell lung cancer. We aim to describe the characteristics, treatment and course of disease in patients with synchronous BM in an advanced NSCLC cohort, and to comparatively analyze prognostic factors for patients with and without BM.
Patients and methods
Of 678 consecutive unselected patients with stage IV NSCLC, 118 presented with synchronous BM (17%; 95% confidence interval [CI]: 15–20%). The patient characteristics, prognostic factors, therapeutic approach and use of specific therapeutic measures including systemic treatment were analyzed.
Results
BM were found more frequently in younger patients, females, non-smokers and those with a lower thoracic stage. 29% of patients with BM exhibited neurologic symptoms. Patients with BM showed worse overall survival (median survival 8.0 vs 9.7 months; HR 1.24 [1.05–1.54]; p=0.045). In multivariable analysis poor performance status at diagnosis showed the strongest negative association with survival.
Conclusion
Synchronous BM are frequent among patients with NSCLC even in early thoracic stages and negatively impact survival. Based on the findings presented in this paper, a therapy algorithm for treating BM is proposed, with systemic therapy being one valuable option.