Prognostic Factors and Scoring Systems for Non-Small Cell Lung Cancer Patients Harboring Brain Metastases Treated with Gamma Knife Radiosurgery.

Tuberculosis and Respiratory Diseases

article

Eom, Jung Seop¹  Cho, Eun Jung¹  Baek, Dong Hoon¹  Lee, Kyung Nam¹  Shin, Kyunghwa¹  Kim, Mi Hyun¹  Lee, Kwangha¹  Kim, Ki Uk¹  Park, Hye Kyung¹  Kim, Yun Sung¹  Park, Soon Kew¹  Cha, Seong Heon²  Lee, Min Ki¹ 

[1] Departments of Internal Medicine Pusan National University School of Medicine;Departments of Neurosurgery, Pusan National University School of Medicine

关键词: Carcinoma;    Non-Small-Cell Lung;    Neoplasm Metastasis;    Brain;    Radiosurgery;    Prognosis;   

DOI  :  10.4046/trd.2012.72.1.15

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

BACKGROUND The survival of non-small cell lung cancer (NSCLC) patients with brain metastases is reported to be 3~6 months even with aggressive treatment. Some patients have very short survival after aggressive treatment and reliable prognostic scoring systems for patients with cancer have a strong correlation with outcome, often supporting decision making and treatment recommendations. METHODS: A total of one hundred twenty two NSCLC patients with brain metastases who received gamma knife radiosurgery (GKRS) were analyzed. Survival analysis was calculated in all patients for thirteen available prognostic factors and four prognostic scoring systems: score index for radiosurgery (SIR), recursive partitioning analysis (RPA), graded prognostic assessment (GPA), and basic score for brain metastases (BSBM). RESULTS: Age, Karnofsky performance status, largest brain lesion volume, systemic chemotherapy, primary tumor control, and medication of epidermal growth factor receptor tyrosine kinase inhibitor were statistically independent prognostic factors for survival. A multivariate model of SIR and RPA identified significant differences between each group of scores. We found that three-tiered indices such as SIR and RPA are more useful than four-tiered scoring systems (GPA and BSBM). CONCLUSION: There is little value of RPA class III (most unfavorable group) for the same results of 6-month and 1-year survival rate. Thus, SIR is the most useful index to sort out patients with poorer prognosis. Further prospective trials should be performed to develop a new molecular- and gene-based prognostic index model.

【 授权许可】

CC BY-NC