The incidence and prognosis of brain metastasis after radical chemoradiotherapy in non-small cell lung cancer

Abstract

Objective The prognosis of lung cancer brain metastasis is affected by many factors. This study was to analyze the incidence of brain metastasis (BM) in patients with stage Ⅱ-Ⅲ non-small cell lung cancer (NSCLC), undergoing radical chemoradiotherapy, and to study the factors affecting prognosis of survival. The values of DS-GPA and Lung-mol GPA, two prognostic index models, were compared in prognosis of patients with specific BM types. Methods A total of 98 patients with stage Ⅱ-Ⅲ NSCLC who underwent radical chemoradiotherapy were enrolled into the database of the Cancer Hospital of Fudan University, from January 2005 to December 2014. A total of 98 patients with brain metastases after treatment were screened and collected. Univariate and multivariate analyses were performed on factors that may affect their survival prognosis. The survival rate was compared using the Log-rank test. The abilities of the two prognostic index models to predict survival were compared by ROC's area under the curve (AUC). Results The incidence of brain metastases in patients with stage Ⅱ-Ⅲ primary NSCLC after radical chemoradiotherapy was 12.6%. Univariate analysis showed that gender, brain metastasis KPS score, pathological type, initial clinical stage, gene status, TKI treatments, brain radiotherapy had an effect on patients' survival (P<0.05); multivariate analysis showed that gene status, brain metastasis KPS score and TKI treatments were closely related to survival (P<0.05). The AUC of the DS-GPA model predicted survival was 0.588, and the AUC of the Lung-mol GPA model was 0.608. Conclusions The gene status, TKI treatment, and KPS scores of BM patients are related to survival in this study. The two prognostic index models of DS-GPA and Lung-mol GPA have limited application value for prognosis evaluation of these patients. New prediction models need to be further validated and explored in large sample populations. Key words: Non-small cell lung cancer; Brain metastases; Chemoradiatherapy; Prognostic index model