Metastasis features of 546 patients with stage IV non-small cell lung cancer at first visit and the significance in radiotherapy

Abstract

Objective To investigate the clinical metastasis features and the possibility of 3 dimensional radiotherapy of stage Ⅳ non-small cell lung cancer (NSCLC). Methods The clinical materials of 546 patients with stage Ⅳ NSCLC and the relationship b T and N stage and metastasis were retrospectively analyzed. Results In 546 patients with stage Ⅳ NSCLC, the number with bone metastasis was 294, the number with brain metastasis was 167 , the number with lung metastasis was 137 , the number with liver metastasis was 79, the number with adrenal gland metastasis was 66, 37 with lymph node metastasis, 35 with subcutaneous metastasis and 10 with other organ metastasis. The number with single organ metastasis was 379 ( 69. 4％ ) ,in which 37. 7％ with bone metastasis, 19. 8％ with brain metastasis,16. 9％ with lung metastasis ,7. 4％ with liver metastasis, 7. 4％ with adrenal gland metastasis , 4. 5％ with lymph node metastasis ,5. 5％ with subcutaneous metastasis and 0. 8％ with other organ metastasis. The bone metastasis probability of T3 +4 patient was similar with T1+2 ( 69. 4％ , 30. 6％ , X2 = 7. 65 , P = 0. 067 ) , but N2+3 patient was more than No+1 ( 69. 7％ , 30. 3％ , X2 = 7. 89 , P = 0. 044) . The brain metastasis probability of T3 +4 patient was more than T1 +2 ( 70. 7％ , 29. 3％ , X2 = 10. 64 ,P = 0. 018) , but N2+3 patient was similar with N0+1 ( 54. 5％ ,45. 5％ , X2 = 7. 14 ,P = 0. 079) , and N1+3 +3 patient was more than N0 ( 86. 8％ , 13. 2％ ,X2 = 10. 26 ,P = 0. 024) . Conclusions In 546 patients with stage Ⅳ NSCLC , the most common metastatic organ is bone, the second is brain, the third is lung, the forth is liver, followed by adrenal gland; single organ metastasis is more common than multiple organ metastasis. The later the T stage is, the more severe is the metastasis. Through 3 dimensional radiotherapy, not only the quality of life of some stage Ⅳ patients is improved, but also the survival time was prolonged observably. Key words: Carcinoma,non-small lung; Neoplasm metastasis; Radiotherapy,three-dimensional