Analysis Of Risk Factors Affecting The Prognosis Of Patients With Non-small Cell Lung Cancer With Brain Metastases

Objective:To investigate the clinical characteristics and prognostic factors of brain metastases from non-small cell lung cancer.Methods: The clinical data of 153 patients with brain metastases from non-small cell lung cancer admitted to Liaoning Cancer Hospital and Institute from January 2013 to December 2016 were analyzed.We collected the case type of primary lesion,KPS score,status of extracranial metastases and treatment methods,and analyzed them by kaplan-meier method and statistical methods of univariate and multivariate analysis.Result: The median age of diagnoses was 57 years.There were 88(57.5%)males and 65females(42.5%).The pathological types of primary lung cancer are adenocarcinoma 124cases(81.0%),there were 16 cases of squamous cell carcinoma(10.4%),adenosquamous carcinoma 7(4.6%)patients,and six other cases(4%).56 patients(36.6%)had single brain metastases and 97 patients(63.4%)had more than 2 brain metastases.88 cases of supratentorial brain metastasis(57.5%),only 11(7.2%)were subtentorial and 54(35.3%)were both.The 1-year,2-year and 5-year survival rates of these patients were66.7%,37.9% and 3.3%,respectively.KPS score and treatment style were independent factors affecting the survival of NSCLC patients(P<0.05),while pathological type,number of brain metastases and GPA were not independent risk factors(P >0.05).11 patients had no treatment or only received symptomatic treatment with steroids,142 patients received active treatment.Active treatment includes WBRT,targeted therapy,WBRT combined surgery,WBRT combined targeting,and WBRT combined SRS,among which the effect of surgery combined WBRT and WBRT combined targeting is better than that of WBRT(p<0.05)alone.Conclusion: This study concluded that KPS score and treatment is independent risk factors for brain metastases of non-small cell lung cancer.The overall survival rate of WBRT-based comprehensive treatment is better,and treatments should be individualized for all patients.