Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases

İnal, Ali; Kodaz, Hilmi; Odabaş, Hatice; Duran, Ayşe Ocak; Şeker, Mehmet; İnanc, M.; Elkıran, Emin Tamer; Gunaydin, Yusuf; Menekşe, Serkan; Topcu, Turkan Ozturk; Urakçı, Zuhat; Taştekin, Didem; Bilici, Mehmet; Cihan, Şener; Geredeli, Çağlayan; Sezer, Emel; Uncu, Doğan; Arpaci, Erkan; Öztürk, Bayram; Bal, Öznur; Uysal, Mükremın; Tanrıverdi, Özgür; Gümüş, Mahmut; Ustaalioğlu, Bala Basak Oven; Suner, Ali; Cokmert, Suna; Hacıbekiroğlu, İlhan; Aydın, Kübra; Işıkdoğan, Abdurrahman

doi:10.4103/0973-1482.176417

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…The improvements in OS observed in this study might reflect the changes in staging procedures and the availability of better antineoplastic and supportive treatments during the study period. Some of the adverse prognostic factors found in the multivariate analyses, such as the presence and the number of extracranial metastases and the performance status, were also described in other series (39,40). The association of metachronous brain metastases with better OS was also reported by Enders et al (37), although, in their study, this association was not statistically significant.…”

Section: Discussionsupporting

confidence: 67%

A modified recursive partitioning analysis for predicting overall survival in patients with non-small cell lung cancer and central nervous system metastases

et al. 2019

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Background: Non-small cell lung cancer (NSCLC) is a major cause of brain metastases. Nonetheless, patients with central nervous system (CNS) spread are poorly represented in clinical trials. We sought to evaluate the overall survival (OS) of patients with NSCLC and CNS metastases. Methods: Patients with NSCLC and CNS metastases treated at A. C. Camargo Cancer Center from January 2007 to December 2017 were selected. The primary endpoint was OS following the diagnosis of CNS metastasis. The Kaplan-Meier method was applied to calculate OS. Prognostic factors were assessed by the Cox Proportional Hazards model. As an exploratory analysis, a survival tree was generated based upon the two most statistically significant variables in the multivariate model and one additional clinically meaningful variable.Results: In total, 311 patients were included. Median OS was 10.3 months (95% CI, 8.7-13.1 months). ECOG performance status 2-4 (HR 2.12; 95% CI, 1.40-3.20; P<0.01) and the absence of a driver mutation (HR 3.30; 95% CI, 1.85-5.90; P<0.01) were strongly associated with worse OS. A Modified Recursive Partitioning Analysis (mRPA) was developed based on the curves generated by the survival tree. mRPA stratified our cohort in four subgroups with significantly different OS (3.1 to 43 months) and it outperformed both RPA and GPA in predicting OS in our population.Conclusions: OS in our cohort was better than previously reported. However, prognosis is widely variable and is mostly dictated by performance status and the presence of a driver mutation.

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Section: Discussionsupporting

confidence: 67%

A modified recursive partitioning analysis for predicting overall survival in patients with non-small cell lung cancer and central nervous system metastases

et al. 2019

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“…The search strategy returned 1890 articles following removal of duplicated papers. After title and abstract followed by full-text screening, fifteen studies [ 5 , 6 , 8 , 12 , 13 , 18 , 21 , 23 – 25 , 31 , 32 , 41 , 50 , 52 ] included data on multivariate HR (as opposed to univariate), meeting our inclusion criteria, and were included in our review and meta-analysis (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The mean study duration was 110.67 months, and the mean follow-up duration for OS and PFS was 17.11 months (Table 1 ). The most common covariates adjusted for in the multivariate models were age ( n = 9) and sex ( n = 7); the minimum number of covariates in a model was 3 [ 21 , 26 ] and the maximum was 11 [ 32 ]. Of the total 3094 pooled participants, 63.2% ( n = 1956) were male.…”

Section: Resultsmentioning

confidence: 99%

“…The overall quality assessment of the studies was noted to be “good”. However, it is important to note that three studies—Hendriks et al (2019) [ 18 ], Inal et al (2018) [ 21 ] and Kim et al (2013) [ 24 ]—reported smoking status to be unknown for 14/255, 66/698 and 26/313 patients, respectively. Another key aspect limiting the quality of these studies is that smoking was self-reported by the patients and the fact that some studies did not explicitly categorise patients as current, former and never smokers, and instead lumped former and never smokers together.…”

Section: Discussionmentioning

confidence: 99%

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The effect of smoking on survival in lung carcinoma patients with brain metastasis: a systematic review and meta-analysis

et al. 2022

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The effects of smoking on survival in BM patients have yet to be reviewed and meta-analysed. However, previous studies have shown that smokers had a greater risk of dying from lung cancer compared to non-smokers. This meta-analysis, therefore, aimed to analyse the effects of cigarette smoking on overall survival (OS) and progression-free survival (PFS) in lung cancer BM patients. PubMed, Embase, Web of Science, Cochrane and Google Scholar were searched for comparative studies regarding the effects of smoking on incidence and survival in brain metastases patients up to December 2020. Three independent reviewers extracted overall survival (OS) and progression-free survival data (PFS). Random-effects models were used to pool multivariate-adjusted hazard ratios (HR). Out of 1890 studies, fifteen studies with a total of 2915 patients met our inclusion criteria. Amongst lung carcinoma BM patients, those who were smokers (ever or yes) had a worse overall survival (HR: 1.34, 95% CI 1.13, 1.60, I2: 72.1%, p-heterogeneity < 0.001) than those who were non-smokers (never or no). A subgroup analysis showed the association to remain significant in the ever/never subgroup (HR: 1.34, 95% CI 1.11, 1.63) but not in the yes/no smoking subgroup (HR: 1.30, 95% CI 0.44, 3.88). This difference between the two subgroups was not statistically significant (p = 0.91). Amongst lung carcinoma BM patients, smoking was associated with a worse OS and PFS. Future studies examining BMs should report survival data stratified by uniform smoking status definitions.

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Microwave ablation as local consolidative therapy for patients with extracranial oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment

Yang

et al. 2019

J Cancer Res Clin Oncol

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Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases

Abstract: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options.

Cited by 5 publications

References 25 publications

A modified recursive partitioning analysis for predicting overall survival in patients with non-small cell lung cancer and central nervous system metastases

A modified recursive partitioning analysis for predicting overall survival in patients with non-small cell lung cancer and central nervous system metastases

The effect of smoking on survival in lung carcinoma patients with brain metastasis: a systematic review and meta-analysis

Microwave ablation as local consolidative therapy for patients with extracranial oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment

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