| Objective: This retrospective study aimed to explore the risk factors for brain metastasis and the prognostic factors for overall survival(OS)in patients with limited-stage small cell lung cancer(LS-SCLC)who had no brain metastases on MRI and did not receive prophylactic cranial irradiation(PCI)after first-line chemoradiotherapy.Methods: A total of 107 patients between January 2013 and December 2017 from Hebei Medical University Fourth Hospital were enrolled into this study.The patients were treated with etoposide/platinum chemotherapy and thoracic radiation therapy with involved—field irradiation.Median dose of radiotherapy was 60Gy(50-64Gy).Result:Median follow-up was 18.8 months(range,7.9 to 65.1 months)and median follow-up of survival patients was 26.7 months(range,18.8 to 65.1 months).Median OS of the whole cohort was 20.1 months,and the 1-,2-and 3-year OS rates were 84.9%,44.9% and 25.9%,respectively.Median Brain-metastasis-free survival(BMFS)was 23.1 months and 1-,2-and 3-year BMFS rates were 69.0%,49.9% and 40.7%,respectively.Fifty patients(46.7%)developed BM during the follow-up period,and the median time to brain metastases was 10.7 months(4.8 to 31.1 months).Multivariate analysis showed that the number of chemotherapy cycles(P=0.019),the response to initial treatment(P=0.011)and the time of thoracic radiotherapy(TRT)(P=0.044)were independent prognostic factors of OS.The clinical stage(P=0.008),the response to initial treatment(P=0.024)and the time of thoracic radiotherapy(P=0.028)were the independent prognostic factors of BMFS.Conclusion:The results of our study demonstrated that clinical stage,the response to initial treatment,ealy or late thoracic radiotherapy and the number of chemotherapy cycles affected the overall survival and brain metastasis for patients who did not receive PCI after first-line chemoradiotherapy.PCI is recommended to be the standard treatment because of high incidence of brain metastasis. |
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