Risk Factors In Non-small Cell Lung Cancer Brain Metastases Study To Assess The Effect Of Targeted Therapy In Patients With Brain Metastases

ObjectivesThe morbidity of brain metastasis (BM) of non-small cell lung cancer (NSCLC) reaches up to30%-50%. The occurring risk factors of brain metastasis of patients of NSCLC are yet undefined. This study is to evaluate risk factors of brain metastasis of patients of NSCLC through data analysis of110patients treated at Peking Union Medical College Hospital (PUMCH), and to evaluate the effect of EGFR-TKI targeted therapy in patients who have got BM already.Materials and methodsWe retrospectively randomly reviewed the medical charts of patients found to have NSCLC in PUMCH between2008to2011. The set of standard for:random selection; To deadline, cases perfect follow-up; Lung cancer types for NSCLC; Already testing EGFR and K-ras mutation or conditions for testing. At last we got110cases, in which22were diagnosed BM. Expected risk factors included age, sex, smoking history, family history, initial position of cancer, pathological type, EGFR mutations and K-ras mutations. According to whether under the action of function of each possible risk factor in patients with NSCLC, we counted the number of BM and no BM, then calculated the χ2and Odds Ratio (OR), to confirm if there was contact between expected risk factor and BM. In patients who have already got BM, we analyse the relation between EGFR mutation, targeted therapy and survival time to definite the effect of targeted therapy.ResultsAfter an analysis, patients with the age<55years old were more likely to have brain metastasis. Gender, smoking history, family history, initial position of cancer and K-ras mutations did not have obvious effects on BM. The patients with pathological type of adenocarcinoma had more risk of brain metastasis while squamous cell carcinoma had less; Patients with EGFR mutations occurred more brain metastasis.In patients who have got BM, targeted therapy have obvious effect in ones who have EGFR mutations.ConclusionFor patients with NSCLC, the main risk factors of brain metastasis happening are age, pathological type, and EGFR mutations. Age≤55years old, pathologic type being adenocarcinoma, and presence of EGFR mutations are important positive risk factors. We hope to have close follow-up and intervention for the NSCLC patients with many risk factors, to decrease the risk of brain metastases occuring, and to improve the overall survival and prognosis of patients with NSCLC. To patients having the diagnosis of brain metastases, taking individual treatment, especially for patients with EGFR mutations, EGFR-TKI targeted therapy can obtain good effect.