Survival analysis of patients with brain metastases from non-small cell lung cancer with driver gene negative radiotherapy or gamma knife combined radiotherapy and its influencing factors
XIA Jing YANG Qiu'an▲#br#
Department of Radiation Oncology, Qilu Hospital of Shandong University Eastern Court, Shandong Province, Ji'nan 250000, China
Objective To investigate the difference of survival time and its related factors in non-small cell lung cancer patients with brain metastases and negative driver gene treated by radiotherapy and gamma knife combined with radiotherapy. Methods A total of 170 patients with brain metastases from non-small cell lung cancer with negative driver gene were selected retrospectively as the research subjects from January 2018 to January 2021 in Qilu Hospital of Shandong University Eastern Court. According to different treatment methods, they were divided into radiotherapy group(135 cases) and gamma knife combined radiotherapy group (35 cases). The difference in survival and related influencing factors were compared between the two groups. Results There was no significant difference between the two groups in overall survival time (P>0.05). Cox regression analysis showed that Karnofsky score ≥70 points （β=-0.963, HR=0.382, 95%CI=0.205-0.710） and maximum lesion volume <10 ml （β=-0.567, HR=0.567, 95%CI=0.335-0.962） in the radio therapy group were protective factors for the overall survival of patients (P<0.05). In the gamma knife combined with radiotherapy group, the control of primary tumor （β=-2.414, HR=0.089, 95%CI=0.021-0.381） and the number of metastatic lesions less than 4 （β=-2.730, HR=0.065, 95%CI=0.013-0.323） were the protective factors for the overall survivnl of patients (P<0.05). Conclusion Non-small cell lung cancer patients and negative driver gene received radiotherapy alone or gamma knife combined with radiotherapy, and there was no difference in survival time between the two groups. When the primary focus is not effectively controlled or the number of metastatic focus was more than 4, the survival time of patients treated with radiotherapy alone was longer.
夏 婧；杨秋安. 驱动基因阴性非小细胞肺癌脑转移瘤患者放疗或伽玛刀联合放疗生存分析及其影响因素[J]. 中国当代医药, 2022, 29(18): 80-83.
XIA Jing YANG Qiu'an▲. Survival analysis of patients with brain metastases from non-small cell lung cancer with driver gene negative radiotherapy or gamma knife combined radiotherapy and its influencing factors. 中国当代医药, 2022, 29(18): 80-83.
Han F，Li CF，Cai Z，et al.The critical role of AMPK in driving Akt activation under stress，tumorigenesis and drug resistance[J].Nat Commun，2018，9（1）：4728.
[2]
Liu J，Harada B T，He C.Regulation of Gene Expression by N（6）-methyladenosine in Cancer[J].Trends Cell Biol，2019，29（6）：487-499.
[3]
Fischer H，Ullah M，de la Cruz CC，et al.Entrectinib，a TRK/ROS1 inhibitor with anti-CNS tumor activity：differentiation from other inhibitors in its class due to weak interaction with P-glycoprotein[J].Neuro Oncol，2020，22（6）：819-829.
[4]
Kabraji S，Ni J，Lin NU，et al.Drug Resistance in HER2-Positive Breast Cancer Brain Metastases： Blame the Barrier or the Brain?[J].Clin Cancer Res，2018，24（8）：1795-1804.
[5]
Ahmad S，Ricco A，Brown R，et al.Single Institutional Experience of Stereotactic Radiosurgery Alone for First Brain Metastatic Event and Salvage of Second Brain Metastatic Event in a Community Setting with Review of the Literature[J].Front Oncol，2017，7：32.
Holt DE，Gill BS，Clump DA，et al.Tumor bed radiosurgery following resection and prior stereotactic radiosurgery for locally persistent brain metastasis[J].Front Oncol，2015，5：84.
[7]
Cheng G，Zhang Q，Pan J，et al.Targeting lonidamine to mitochondria mitigates lung tumorigenesis and brain metastasis[J].Nat Commun，2019，10（1）：2205.
[10]
Liu J.Initial Approach to Patients with a Newly Diagnosed Solitary Brain Metastasis[J].Neurosurg Clin N Am，2020，31（4）：489-503.
[11]
Uzunalli G，Dieterly AM，Kemet CM，et al.Dynamic transition of the blood-brain barrier in the development of nonsmall cell lung cancer brain metastases[J].Oncotarget，2019，10（59）：6334-6348.
[12]
Bowden G，Kano H，Caparosa E，et al.Gamma knife radiosurgery for the management of cerebral metastases from non-small cell lung cancer[J].J Neurosurg，2015，122（4）：766-772.
[14]
Noordijk EM，Vecht CJ，Haaxma-Reiche H，et al.The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age[J].Int J Radiat Oncol Biol Phys，1994，29（4）：711-717.
[15]
Sanghavi SN，Miranpuri SS，Chappell R，et al.Radiosurgery for patients with brain metastases：a multi-institutional analysis，stratified by the RTOG recursive partitioning analysis method[J].Int J Radiat Oncol Biol Phys，2001，51（2）：426-434.
[16]
Yamamoto M，Serizawa T，Higuchi Y，et al.A Multi-institutional Prospective Observational Study of Stereotactic Radiosurgery for Patients With Multiple Brain Metastases（JLGK0901 Study Update）：Irradiation-related Complications and Long-term Maintenance of Mini-Mental State Examination Scores[J].Int J Radiat Oncol Biol Phys，2017，99（1）：31-40.
[17]
Li J，Brown PD.The Diminishing Role of Whole-Brain Radiation Therapy in the Treatment of Brain Metastases[J].JAMA Oncol，2017，3（8）：1023-1024.
[18]
Andrews DW，Scott CB，Sperduto PW，et al.Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases：phaseⅢresults of the RTOG 9508 randomised trial[J].Lancet，2004，363（9422）：1665-1672.
[19]
Hoffmann C，Distel L，Knippen S，et al.Brain volume reduction after whole-brain radiotherapy：quantification and prognostic relevance[J].Neuro Oncol，2018，20（2）：268-278.
[20]
Asher AL，Alvi MA，Bydon M，et al.Local failure after stereotactic radiosurgery （SRS） for intracranial metastasis：analysis from a cooperative，prospective national registry[J].J Neurooncol，2021，152（2）：299-311.
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