非小细胞肺癌伴同步脑转移：一项回顾性多中心研究（HOT 1701）中预后因素的识别

Non-small cell lung cancer with synchronous brain metastases: Identification of prognostic factors in a retrospective multicenter study (HOT 1701).

作者信息

Ohhara Yoshihito, Kojima Tetsuya, Honjo Osamu, Yamada Noriyuki, Sato Toshitaka, Takahashi Hirofumi, Takamura Kei, Takashina Taichi, Sukoh Noriaki, Tanaka Hisashi, Kawai Yasutaka, Fujita Yuka, Yokoo Keiki, Hommura Fumihiro, Harada Toshiyuki, Honda Ryoichi, Amano Toraji, Dosaka-Akita Hirotoshi, Oizumi Satoshi, Kinoshita Ichiro

机构信息

Department of Medical Oncology, Hokkaido University Hospital, Kita-ku, Japan.

Department of Respiratory Medicine, KKR Sapporo Medical Center, Toyohira-ku, Japan.

出版信息

Neurooncol Adv. 2024 Oct 5;6(1):vdae168. doi: 10.1093/noajnl/vdae168. eCollection 2024 Jan-Dec.

DOI:10.1093/noajnl/vdae168

PMID:39539600

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11558066/

Abstract

BACKGROUND

Non-small-cell lung cancer (NSCLC) is associated with a high incidence of brain metastasis (BM), and the prognosis of patients with NSCLC and BM is poor. This study aimed to identify the prognostic factors and elucidate the survival rates of Japanese patients with NSCLC and BM at initial diagnosis.

METHODS

HOT 1701 is a retrospective multicenter study of patients with NSCLC and BM at initial diagnosis. The medical records of all consecutive patients diagnosed with advanced or recurrent NSCLC and BM at 14 institutions of the Hokkaido Lung Cancer Clinical Study Group Trial (HOT) in Japan were reviewed. The participants were categorized based on the presence or absence of driver mutations. The Kaplan-Meier method was used to estimate median overall survival (OS). Univariate and multivariate analyses were performed to identify prognostic factors in these patients.

RESULTS

Among 566 patients with NSCLC and BM, the median OS was 11.8 months. Patients with driver mutations survived longer than those without driver mutations. The univariate and multivariate analyses revealed 6 independent prognostic factors: age ≥65 years, poor performance status, T factor, absence of driver gene mutations, presence of extracranial metastases, and number of BM. According to the prognostic score based on these 6 factors, the patients were stratified into 3 risk groups: low-, intermediate-, and high-risk, with median OS of 27.8, 12.2, and 2.8 months, respectively.

CONCLUSIONS

We developed a new prognostic model for patients with NSCLC and BM, which may help determine prognosis at diagnosis.

摘要

背景

非小细胞肺癌（NSCLC）与脑转移（BM）的高发生率相关，NSCLC合并BM患者的预后较差。本研究旨在确定预后因素，并阐明日本初诊NSCLC合并BM患者的生存率。

方法

HOT 1701是一项针对初诊NSCLC合并BM患者的回顾性多中心研究。对日本北海道肺癌临床研究组试验（HOT）14家机构中所有连续诊断为晚期或复发性NSCLC合并BM的患者的病历进行了回顾。参与者根据是否存在驱动基因突变进行分类。采用Kaplan-Meier法估计中位总生存期（OS）。进行单因素和多因素分析以确定这些患者的预后因素。

结果

在566例NSCLC合并BM患者中，中位OS为11.8个月。有驱动基因突变的患者比没有驱动基因突变的患者存活时间更长。单因素和多因素分析揭示了6个独立的预后因素：年龄≥65岁、体能状态差、T分期、无驱动基因突变、存在颅外转移和BM数量。根据基于这6个因素的预后评分，患者被分为3个风险组：低风险、中风险和高风险，中位OS分别为27.8、12.2和2.8个月。