Predictive value of clinical characteristics on risk and prognosis of synchronous brain metastases in small‐cell lung cancer patients: A population‐based study

Zhou, Gang; Zhang, Zhiyuan; Yu, Peng; Geng, Ruixuan; Wang, Guige; Ma, Wenbin; Gao, Jun; Zheng, Zhibo; Li, Yongning

doi:10.1002/cam4.4978

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Zhu et al [ 13 ] demonstrated that in NSCLC patients, young age (< 65), female, race, higher tumor grade, advanced T-stage or N-stage, liver metastasis, lung metastasis, bone metastasis were independent risk factors for developing SBM, while female, grade, early T stage, married status, no other site-specific metastases, other race, chemotherapy and radiation treatments were associated with significantly better mLCSS. In another retrospective study based on SEER database, Zhou et al declared that SCLC patients who are black, higher T stage, lung metastases and bone metastases had greater odds of SBM at initial diagnosis, and age ≥ 65, singled, higher T stage, higher N stage, liver metastases and bone metastases were independently related to shorter OS [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Zheng

Wang

et al. 2023

BMC Pulm Med

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Background Patients with pulmonary large cell carcinoma (LCC) have a high incidence of synchronous brain metastases (SBM) and a poor prognosis. Our study was to evaluate the predictive and prognostic value of the clinical characteristics of pulmonary LCC patients with SBM at initial diagnosis by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Methods LCC patients, diagnosed from 2010 to 2019, were identified from the latest SEER database which was released in April 2022. Logistic regression and Cox regression were used to identify the predictive and prognostic factors for LCC patients with SBM. Propensity score matching (PSM) and Kaplan–Meier analyses were applied to assess different therapy modalities. Results A total of 1375 LCC patients were enrolled in this study and 216 (15.7%) of them had SBM at the initial diagnosis. The median overall survival (OS) of LCC patients with SBM was 4 months. Multivariate Cox regression identified age 60–79 (OR 0.57; 95% CI 0.41–0.78; p < 0.001), age ≥ 80 (OR 0.23; 95% CI 0.12–0.45; p < 0.001) and bone metastases (OR 1.75; 95% CI 1.22–2.51; p < 0.001) as significant independent predictors for developing SBM. Multivariable Cox regression revealed that age 60–79, T stage, bone metastases and chemotherapy were independent prognostic factor for OS. The surgery combined with chemotherapy and radiotherapy group, in which all patients were N0 stage and had no other site-specific metastases, exhibited the best median OS of 15 months. Conclusions LCC patients with age < 60 or bone metastases were more likely to have SBM at initial diagnosis. Age, T stage, bone metastases and chemotherapy were independent prognostic factors for OS of LCC patients with SBM. Highly selected patients might achieve the best survival benefit from surgery combined with chemotherapy and radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Zheng

Wang

et al. 2023

BMC Pulm Med

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“…The incidence of brain metastases is 10-20% in patients with NSCLC at diagnosis, and the lifetime incidence has increased up to 50% as a result of an increase in patients' survival 11,12 higher N stage, liver metastases and bone metastases were independently related to shorter OS 14 .…”

Section: Impact Of Therapy On Os Of Patients With Sbmmentioning

confidence: 99%

Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Zheng

Wang

et al. 2022

Preprint

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Background: Patients with pulmonary large cell carcinoma (LCC) have a high incidence of synchronous brain metastases (SBM) and a poor prognosis. Our study was to evaluate the predictive and prognostic value of the clinical characteristics of pulmonary LCC patients with SBM at initial diagnosis by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Methods: LCC patients, diagnosed from 2010 to 2019, were identified from the latest SEER database which was released in April 2022. Logistic regression and Cox regression were used to identify the predictive and prognostic factors for LCC patients with SBM. Propensity score matching (PSM) and Kaplan-Meier analyses were applied to assess different therapy modalities. Results: A total of 1,375 LCC patients were enrolled in this study and 216 (15.7%) of them had SBM at the initial diagnosis. The median overall survival(OS) of LCC patients with SBM was 4 months. Multivariate Cox regression identified age 60–79 (OR: 0.57; 95% CI:0.41–0.78; p <0.001), age ≥80 (OR: 0.23; 95% CI: 0.12–0.45; p <0.001) and bone metastases (OR: 1.75; 95% CI: 1.22–2.51; p <0.001) as significant independent predictors for developing SBM. Multivariable Cox regression revealed that age 60-79, T stage, bone metastases and chemotherapy were independent prognostic factor for OS. The surgery combined with chemotherapy and radiotherapy group, in which all patients were N0 stage and had no other site-specific metastases, exhibited the best median OS of 15 months. Conclusions: LCC patients with age <60 or bone metastases were more likely to have SBM at initial diagnosis. Age, T stage, bone metastases and chemotherapy were independent prognostic factors for OS of LCC patients with SBM. Highly selected patients could achieve the best survival benefit from surgery combined with chemotherapy and radiotherapy.

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“…Patients with BM were subsequently treated with palliative therapy. The standard treatment for SCLC BM is still WBRT, with an overall effective rate (ORR) of approximately 50% -80% ( 5 ). Magnetic resonance imaging (MRI) is a more sensitive technique to detect BM, In the MRI era, the estimated prevalence of BM increased by 14% ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Low radiotherapy dose is suitable for brain metastases in SCLC compared with high dose

Xu,

Zhang,

Han

et al. 2023

Front. Oncol.

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ObjectiveThis study was designed to evaluate the suitable radiotherapy dose in SCLC patients with BM.MethodsA retrospective analysis was performed among 121 patients on the prognosis of BM of SCLC who were admitted to our hospital from 2013 to 2023. They all received first line chemotherapy. 80 patients of them received TRT after chemotherapy. The Chi square method was used to compare the categorical data. Univariate survival analysis was estimated by Kaplan Meier method and the logrank was used to compare survival curves between groups. A multivariate prognostic analysis was made by the Cox proportional hazard model. The iOS and iLC of two groups of low dose and high dose were analyzed after propensity score matching (PSM).ResultsIn all the patients, the median follow-up time was 18.6 months (range 6.30~85.7), the 2-year iOS and iLC rates were 15.4% and 70.3%, respectively, and cerebral necrosis occurred in 2 patients. In univariate analysis related to iOS, extracranial disease control (p=0.023), higher DS-GPA (≥2) (p=0.016), immunotherapy (p=0.049), low-dose(p=0.030), and WBRT+SIB (p=0.009) were significantly associated with an increase in survival rate. After PSM, the 2-year iOS of low dose (n=49) was significantly higher than that of high dose (n=49) (P=0.025), while the 2-year iLC was not significantly improved (P=0.267). In DS-GPA < 2 subgroup, the iOS of low dose group was significantly higher than that of high dose group (p=0.019). In the DS-GPA ≥ 2 subgroup, the 2-year iLC of the low dose group was significantly inferior than that of the high dose group (p=0.044).ConclusionsThe iLC was improved along with increasing radiotherapy dose, but high dose had inferior iOS compared to low dose, while there were not significantly improving iLC when radiotherapy BED >56Gy. But in patients with DS-GPA≥2 subgroup, high dose brought better iLC benefits.

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Predictive value of clinical characteristics on risk and prognosis of synchronous brain metastases in small‐cell lung cancer patients: A population‐based study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 4 publications

References 19 publications

Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Factors for incidence risk and prognosis of synchronous brain metastases in pulmonary large cell carcinoma patients: a population-based study

Low radiotherapy dose is suitable for brain metastases in SCLC compared with high dose

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