Analysis Of Non-small-cell Lung Cancer With Bone Metastasis

Objective:This study aims to identify the prognosis factors affecting overall survival(OS)of non-small-cell lung cancer with bone metastasis.Methods:Sixty-eight patients diagnosed as non-small cell lung cancer with bone metastases from September 2012 to September 2017 in Zhejiang Cancer Hospital were included in this study.All cases received systemic chemotherapy or targeted therapy.Targeted therapy indicates therapies targeting specific mutations only,excluding pan-target and anti-angiogenic treatments.The effect of factors including gender,smoking history,lymph node metastasis,other organ metastases,bone-related events,ECOG score,targeted therapy,radiation therapy,or bisphosphonates applications on patients' overall survival were analyzed by univariate and multivariate analyses,repectively.Results:This cohort of 68 patients includes 45 males and 23 females.32 patients had a smoking history and 36 cases had mediastinal lymph node metastases.41 patients presented other organ metastases.6 patients had solitary bone metastases in the limbs and 28 patients had bone metastasis only in non-limbs.16 cases presented bone-related events.39 out of 68 patients had received targeted therapy,and the others were directly treated with chemotherapy.The median overall survival time of 68 patients was 26 months,and the mean survival time was 37.57 months.Univariate analysis showed that gender,history of smoking,other organs metastases,bone metastasis sites,bone-related events,radiation therapy,or bisphosphonate therapy were not associated with overall survival(p>0.05).In contrast,patients with mediastinal lymph node metastases had significant shorter survival time(p<0.05),while patients received targeted therapy had significant longer survival time(p<0.05),and patients with lower ECOG scores survived longer(p<0.05).Moreover,multivariate Cox regression analysis showed that mediastinal lymph node metastasis and targeted therapy were independent factors affecting the survival time of patients in this cohort(p<0.05).Conclusions:1.Bone metastases in patients with non-small cell lung cancer mainly occurred in non-limbs.2.Patients without mediastinal lymph node metastases or received targeted therapy or with lower ECOG scores had a significant longer overall survival time.3.Mediastinal lymph node metastasis and targeted therapy are independent factors affecting the overall survival time of patients with non-small cell lung cancer with bone metastases.