脑病变局部治疗对多发胸外转移的非小细胞肺癌患者生存的影响。
Impact of Locoregional Therapies for Brain Lesions on Survival in Patients With Non-small Cell Lung Cancer With Multiple Extrathoracic Metastases.
发表日期：2023 Nov
作者：
Kosuke Sakai, Joji Kuramoto, Tomoyuki Takahashi, Yuichiro Kawano, Hiroaki Nishimura, Yoshiki Kuwabara, Akitoshi Kojima, Maiko Sasaki-Toda, Yumiko Ogawa-Kobayashi, Satoshi Kikuchi, Yusuke Hirata, Yuriko Mikami-Saito, Shintaro Mikami, Hiroyuki Kyoyama, Gaku Moriyama, Nobuyuki Koyama, Kazutsugu Uematsu
来源：
Brain Structure & Function
摘要：
非小细胞肺癌 (NSCLC) 患者脑转移的治疗通常包括手术、放疗和化疗（单一或联合治疗）。然而，这些疗法对多发胸外转移的 NSCLC 患者生存的影响尚未确定。因此，在本研究中，我们探讨了在没有驱动突变的情况下，多模式治疗对胸外多发转移的 NSCLC 患者脑转移的预后影响。 胸外多发转移（包括至少一处脑转移）的 NSCLC 患者， 2010年1月1日至2016年12月31日访问埼玉医科大学埼玉县医疗中心并参加本次研究；随访至2021年12月31日。共入组56例患者，其中单发脑转移瘤患者12例，多发性脑转移瘤患者44例。所有患者的中位总生存期 (OS) 为 4.9 个月，单发和多发脑转移患者之间没有显着差异（分别为 3.0 个月和 4.9 个月）。脑转移局部治疗的选择不取决于卡诺夫斯基表现状态（p=0.0862）。在多发性脑转移患者中，接受开颅手术并随后进行全脑放射治疗 (WBRT) 的患者、仅接受 WBRT 的患者以及未接受局部治疗的患者的 OS 分别为 47.7、3.9 和 15.9 个月 (p=0.00382) ）。手术切除后进行放射治疗是多发性脑转移瘤患者的有效治疗选择。然而，单独进行 WBRT 并不能改善预后。版权所有 © 2023 国际抗癌研究所（George J. Delinasios 博士），保留所有权利。
The treatment of brain metastases in patients with non-small cell lung cancer (NSCLC) typically involves surgery, irradiation, and chemotherapy (single or combination therapy). However, the impact of these therapies on the survival of patients with NSCLC with multiple extrathoracic metastases has not yet been determined. Therefore, in the present study, we examined the prognostic effect of multimodal treatment for brain metastases in patients with NSCLC with multiple extrathoracic metastases in the absence of driver mutations.Patients with NSCLC with multiple extrathoracic metastases (including at least one brain metastasis), who visited Saitama Medical Center, Saitama Medical University from January 1, 2010 to December 31, 2016, were enrolled in this study; follow-up was conducted until December 31, 2021.A total of 56 patients were enrolled, including 12 and 44 patients with single and multiple brain metastases, respectively. The median overall survival (OS) for all patients was 4.9 months, and did not differ significantly between patients with single and multiple brain metastases (3.0 vs. 4.9 months, respectively). The selection of locoregional treatment for brain metastases did not depend on Karnofsky performance status (p=0.0862). Among patients with multiple brain metastases, the OS for those who underwent craniotomy followed by whole brain radiation therapy (WBRT), those who received only WBRT, and those treated without locoregional therapy was 47.7, 3.9, and 15.9 months, respectively (p=0.00382).Surgical resection followed by radiation therapy is an effective treatment option for brain metastases in patients with multiple metastases. However, WBRT alone did not improve prognosis.Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.