Risk analysis of brain metastases in limited-stage small cell lung cancer (LS-SCLC)achieving complete remission after thoracic radio-chemotherapy
Shen Bin1,2, Liu Jianjiang2, Qiu Guoqin3, 4, Ji Yongling3, 4, Du Xianghui3, 4, Yang Yang3, 4
1 Zhejiang Chinese Medical University, Hangzhou 310053, China; 2 Department of Radiation Oncology, Shaoxing People's Hospital, Shaoxing 312000, China; 3 Department of Thoracic Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou 310005, China; 4 Zhejiang Key Laboratory of Radiation Oncology, Hangzhou 310005, China
Abstract：Objective Small cell lung cancer (SCLC) is a highly malignant tumor with a high risk of brain metastasis (BMs). The purpose of this study was to evaluate the clinical factors affecting the occurrence of BMs in patients with stage IIB-IIIB SCLC who achieved complete remission (CR) after thoracic radio-chemotherapy. Methods Clinical data of 191 patients with stage IIB-IIIB SCLC who achieved CR after thoracic radio-chemotherapy in Zhejiang Cancer Hospital from January 2009 to April 2016 were retrospectively analyzed. Common clinical factors related to the risk of BMs, including gender, age, thoracic radiotherapy dose, combined mode of radiotherapy and chemotherapy, pretreatment serum NSE and LDH, whether PCI was performed, TMN stage and PS score, were analyzed using log-rank method for univariate analysis, COX regression method for multivariate analysis and Kaplan-Meier method to plot the survival curve. Results Univariate analysis showed that pretreatment LDH level≥240IU, pretreatment NSE ≥17 ng/ml and no PCI were positively correlated with the risk of BMs (all P<0.05). Multivariate analysis showed that the risk of BMs was only positively correlated with pretreatment LDH≥240IU [HR: 1.90, 95%CI(1.07-3.37), P=0.029], and no PCI [HR:2.08, 95%CI(1.17-3.72), P=0.013]. Conclusions Pretreatment serum LDH levels provide important value for predicting the risk of BMs in patients with stage IIB-IIIB SCLC who achieve CR after thoracic radio-chemotherapy.
Shen Bin,Liu Jianjiang,Qiu Guoqin et al. Risk analysis of brain metastases in limited-stage small cell lung cancer (LS-SCLC)achieving complete remission after thoracic radio-chemotherapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(7): 611-616.
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