JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (7): 61-66.doi: 10.6040/j.issn.1671-7554.0.2016.1606

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Association analysis of brain metastases after prophylactic cranial irradiation in local disease small cell lung cancer: a bicenter study

ZENG Haiyan1,2*, LI Rui3*, SUN Xindong2,4, XIE Peng2,4, MENG Xue2,4, FAN Bingjie2,4, LI Wanlong2,4, YUAN Shuanghu2,4   

  1. 1. School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250022, Shandong, China;
    2. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, China;
    3. Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, Sichuan, China;
    4. Shandong Academy of Medical Sciences, Jinan 250022, Shandong, China
  • Received:2016-12-03 Online:2017-07-10 Published:2017-07-10

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Abstract: Objective To explore the risk factors for brain metastases(BM)after prophylactic cranial irradiation(PCI)and to develop a hazard model to guide the clinical practice in local-disease small cell lung cancer(LD-SCLC). Methods The clinical data of 257 LD-SCLC cases treated during July 2003 and June 2014 were retrieved. BM free survival(BMFS)and overall survival(OS)were estimated using Kaplan-Meier method. High risk factors and the 山 东 大 学 学 报 (医 学 版)55卷7期 -曾海燕,等.局限期小细胞肺癌患者预防性脑照射后脑转移的关联分析:双中心研究 \=-hazard model for BM were identified using Cox regression analyses. Results During the median follow-up of 34 months, BM occurred in 47(18.3%)patients. Univariate analyses indicated that performance status(PS)(P=0.040)and thoracic radiotherapy schedule(P=0.001)were associated with BM. Multivariate analyses showed that PS>1(P=0.017), thoracic hyperfractionated accelerated radiotherapy(HART)(P=0.004), and long duration of radiotherapy(SER)(P=0.035)were independent risk factors for BM, and surgery(P=0.035)was the independent protective factor for BM. In addition, surgery and thoracic radiotherapy biological effective dose(BED)were independent protective factors for OS, while age≥60 yr, PS>1 and PCI above standardized dosage were independent risk factors for OS. Conclusion Poor PS, thoracic HART and long SER are independent risk factors for BM after PCI in LD-SCLC. High dose of PCI does not prolong BMFS but shortens OS.

Key words: Prophylactic cranial irradiation, Risk factor, Brain metastasis, Hazard model, Local-disease small cell lung cancer

CLC Number: 

  • R734.2
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