Prognostic Factors On Bone Metastasis For Lung Cancer

Objective:Lung cancer is one of the most common malignant tumor in the worldwide and middle-late stage lung cancer patients are easily to occur bone metastasis,it seriously affect patient’s long-term survival and life quality.The purpose of this subject was to study prognostic factors of Lung cancer with bone metastasis.Methods:Retrospective analysis 54 cases of bone metastasis for lung cancer patients from Jan 2007 and Dec 2011. Medical records including:age、sex、smoking history、tumor’s pathological type、clinical stages、performance status scores、the size of the primary focus、the number of the primary focus、the position of the primary focus、the number of bone metastasis、the position of bone metastasis、presence of bone pain、Whether with other viscera metastasis、whether to accept the bone metastases chemotherapy、whether to accept the bone metastases radiation therapy、whether to accept the bisphosphonates、Alkaline phosphate 、 Lactate dehydrogenase 、 Carcinoembryonic antigen 、 Neural specificity enolization enzyme、Cytokeratin fragment 19 etc. Visceral metastasis39 males and 15 females with a median age of 62.5 years(45-80 years) were entered into this study.54 cases bone metastasis were detected by thoracic radiographs,CT,MRI and bone scanning,among them 34 cases(62.9%),squamous cell carcinoma 15(27.8%),small cell lung carcinoma 3(5.6%) and adeno-squamous carcinoma 2(3.7%).It adopted Kaplan-Meier survival curve and Cox comparative hazards model to analyse and find influence the relative risk factor of prognosis.Results:The investigation was finished at the end of Sep. 2013 and during the investigation follow-up is 96.3%(52/54).It is more common that peripheral lung cancer in primarytumors.Among lung cancer bone scanning of 34 cases adenocarcinoma(62.9%) is one of the most,squamous cell carcinoma 15(27.8%),small cell lung carcinoma 3(5.6%) and adeno-squamous carcinoma 2(3.7%).It is in the order of bone metastases good location that spine, chest, pelvis, limbs, skull and thoracic vertebra, lumbar spine, ribs for the top three. The 6-months,1-year and 2-years survival rates of bone metastasis on lung cancer were 74.1%(40/54), 31.5%(17/54), and 9.3%(5/54) respectively. The median survival time was 9 months. Single factor analysis showed that the significant prognostic factors included age、sex、the number of the primary focus、the size of the primary focus、the position of the primary focus、the number of bone metastasis and visceral metastasis、presence of bone pain、Whether with other viscera metastasis、whether to accept the bone metastases chemotherapy、whether to accept the bone metastases radiation therapy、whether to accept the bisphosphonates, Alkaline phosphate 、 Lactate dehydrogenase, Carcinoembryonic antigen, Neural specificity enolization enzyme, Cytokeratin fragment 19. Multiple factors analysis showed that the significant prognostic factors included patients’ general condition, tumor’s pathological type, the number of bone metastasis and visceral metastasis.Conclusions:1. It is more common that peripheral lung cancer in primary tumors. Among lung cancer bone scanning of 34 cases adenocarcinomais one of the most, squamous cell carcinoma, small cell lung carcinoma and adeno-squamous carcinoma.2. It is in the order of bone metastases good location that spine, chest, pelvis, limbs, skull and thoracic vertebra, lumbar spine, ribs for the top three.3. Single factor analysis showed that the significant prognostic factors included patients’ general condition、tumor’s pathological type、the number of bone metastasis、visceral metastasis、AKP、LDH and CEA.4.Patients’ general condition, tumor’s pathological type, the number of bone metastasis and visceral metastasis can be used to evaluate the prognosis of bone metastasis for lung cancer.