Influencing factors for prognoses of pulmonary adenocarcinoma patients with leptomeningeal metastases: a single-center study
10.3760/cma.j.cn115354-20211021-00674
- VernacularTitle:单中心肺腺癌脑膜转移的预后影响因素分析
- Author:
Weifeng MA
1
;
Milan ZHANG
;
Tao ZHANG
;
Mengge ZHANG
;
Linlin JIA
;
Yongshi TENG
;
Shuhua DAI
;
Huiqin LIU
;
Yushu JIANG
;
Lingzhi QIN
;
Lipin YUAN
;
Wei LI
Author Information
1. 郑州大学人民医院，河南省人民医院神经内科，郑州 450000
- Keywords:
Pulmonary adenocarcinoma;
Leptomeningeal metastases;
Tyrosine kinase inhibitor;
Prognosis
- From:
Chinese Journal of Neuromedicine
2022;21(1):28-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognoses of pulmonary adenocarcinoma patients with leptomeningeal metastases (LM) and explore their influencing factors.Methods:A retrospective analysis was performed. The clinical data, imaging features and treatment plans of pulmonary adenocarcinoma patients with LM admitted to our hospital from January 2010 to June 2021 were collected. Overall survival (OS) was used as the prognostic evaluation criterion and patients were divided into good prognosis group (OS≥6 months) and poor prognosis group (OS<6 months) accordingly. Logistic regression analysis was used to evaluate the influencing factors for prognoses of pulmonary adenocarcinoma patients with LM. These patients were grouped according to different Karnofsky performance status (KPS) scores and different treatment methods, and survival curves were drawn to compare their OS.Results:A total of 173 pulmonary adenocarcinoma patients with LM were enrolled in the study, including 75 with good prognosis and 87 with poor prognosis. There were significant differences in the KPS scores, pulmonary adenocarcinoma lesion controlled status, giving third generation tyrosine kinase inhibitor (TKI) therapy or not, giving systemic chemotherapy and/or whole brain radiotherapy or not between the two groups ( P<0.05). Multivariate Logistic regression analysis showed that KPS scores and pulmonary adenocarcinoma lesion controlled status were independent influencing factors for prognoses ( OR=4.186, 95%CI: 1.583-11.070, P=0.004; OR=4.198, 95%CI: 1.499-11.760, P=0.006). Survival curves showed median OS of 8.2 months for all patients ( 95%CI: 6.5-9.8). The OS in patients with low-risk(KPS scores≥60) was significantly higher than that in patients with high-risk(KPS scores<60), that in patients accepted TKI treatment was significantly higher than that in patients not accepted TKI treatment, and that in patients accepted TKI and systemic chemotherapy was significantly higher than that in patients accepted TKI alone ( P<0.05). Conclusion:Patients with high KPS scores and controlled pulmonary adenocarcinoma can have relatively good prognosis; TKI treatment and combination therapy may prolong OS of these patients.
