1.Study on risk factors of brain metastases of locally advanced non-small-cell lung cancer
Xia CA0 ; An-lan NG WA ; Pei YANG ; Yuan YUAN ; Sheng-qi WU ; Rong-xi LUO
Cancer Research and Clinic 2012;24(1):24-27
Objective To evaluate the prognostic factors in locally advanced non-small-cell lung cancer (LA-NSCLC) for selectively carrying out prophylactic cranial irradiation (PCI).Methods 114 patients with LA-NSCLC between Jun 2006 and Oct 2010 were retrospectively analyzed. Related risk factors and features about brain metastases were analyzed.Results The 2-year incidence rate of brain metastases was 31.58 % (36/114),the first brain metastases was 20.18 % (23/114),and sole brain metastases was 9.65 %(11/114),respectively.Variables involved in the equation of binary logistic regression analysis were pathology (OR =5.892) and treatment mode(OR =2.888).The incidence rate of brain metastases in patients of non-squamous carcinoma and single treatment mode was higher than others (P < 0.01) Model fitting is better (P > 0.05).Overall accuracy rate of predicting brain metastases is 67.7 %.The increased rate of lactate dehydrogenase in the patients with brain metastases or death was 17.54 %, which was higher than that in the survival patients without brain metastases (P < 0.01).At the same time,the station number and the number of mediastinal lymph node metastases were positively correlated (r =0.716, P < 0.01).The incidence rate of brain metastases or mortality rate was higher in the adenocarcinoma cases than that in the squamous carcinoma cases (P < 0.01,P < 0.05),with more frequent occurrence of mediastinal metastases.The mean diameter of squamous carcinoma and adenocarcinoma were 5.8 cm and 3.9 cm, respectively (P < 0.01).Conclusions The incidence rate of brain metastases was higher in patients with single treatment.Large primary tumors, high lactate dehydrogenase, non-squamous carcinoma, multiple stations, and multiple mediastinal lymph nodes metastases can be regarded as risk factors of brain metastases to perform PCI.