Abstract
Objective To explore the related factors for the prognosis in elderly cancer patients with cerebral metastases, to study the adaptability of brain metastasis in recursive partitioning analysis(RPA)and the prognosis Assessment (GPA) Scale, in order to provide the basis for the prognosis assessment and treatment in the elderly patients with brain metastasis. Methods A retrospective analysis was studied in 102 elderly cancer patients with brain metastasis (aged 60 years and over) with complete follow-up data in our hospital from January 2005 to January 2012. Survival analysis was performed by using the Kaplan-Meier method. Univariate analysis of ethnicity, age, Karnofsky score, gender, smoking, primary tumor origin, the number of intracranial metastatic tumor, intracranial and extracranial metastasis, the efficacy of treatment for primary tumor, the treatment of brain metastases were analyzed by Log-rank test. Results The median survival time was 6 months. The 6-month and 12- month survival rates were 54.90% and 16.67% respectively. Univariate analysis showed that Karnofsky score, smoking, the number of intracranial metastatic tumor, time to diagnosis and treatment, the efficacy of treatment for primary tumor and other underlying diseases were the relative factors for prognosis of elderly cancer patients with brain metastases (χ2= 20.828, 5.737, 7.395, 5.379, 11.556, 6.844, all P<0.05). Cox multivariate regression analysis showed that the Karnofsky score, the number of intracranial metastatic tumor, the efficacy of treatment for primary tumor and other underlying diseases were the independent prognostic factors (all P<0.05). The median survival periods in RPA class Ⅰ, Ⅱ, Ⅲ were 11, 7, 4 month respectively (χ2=27.358, P<0.001). The median survival periods in GPA classⅠ, Ⅱ, Ⅲ-Ⅳ were 5, 8, 13 months respectively (χ2=29.570, P<0.001). Conclusions Karnofsky score, the number of intracranial metastatic tumor, the efficacy of treatment for primary tumor and other underlying diseases are the independent factors for the prognosis in elderly cancer patients with cerebral metastases. RPA and GPA classification have a good adaptability in elderly patients with brain metastases. Key words: Neoplasm metastasis; Brain Prognosis
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