Study on high risk factors,treatment options and related survival time of meningeal metastasis in non-small cell lung cancer with brain metastasis
Objective To investigate the risk factors,treatment strategies and related survival time of meningeal metastasis in patients with non-small cell lung cancer with brain metastasis.Methods A total of 170 patients with brain metastasis of non-small cell lung cancer in Fujian Cancer Hospital were analyzed retro-spectively.They were divided into the combined meningeal metastasis group and the non-combined meningeal metastasis group.The basic clinical characteristics,molecular pathological characteristics,survival time and treatment options were compared between the two groups.At the same time,the clinical survival information of 63 patients with brain metastasis and meningeal metastasis of non-small cell lung cancer was tracked and analyzed,and the progression time and survival time of meningeal metastasis in patients with brain metastasis of non-small cell lung cancer were analyzed.Results Among the 121 patients with epidermal growth factor(EGFR)mutation-positive non-small cell lung cancer and brain metastasis,51 patients(42.15％)had menin-geal metastasis.While only 24.49％(12/49)of patients with brain metastases from non-small cell lung cancer without EGFR mutation had meningeal metastasis(x2=4.663,P=0.031).49.20％(31/63)of patients with meningeal metastasis received intrathecal chemotherapy,compared with no meningeal metastasis,the differ-ence was statistically significant(x2=64.393,P＜0.001).There was no significant difference in other treat-ment methods,such as surgery,radiotherapy,chemotherapy,targeting,anti-tumor angiogenesis and immuno-therapy(P＞0.05).The median time from the discovery of lung cancer to the occurrence of meningeal metas-tasis in 63 patients with non-small cell lung cancer with meningeal metastasis was 35 months,with a 95％con-fidence interval of 27.230-42.770.The median time from the discovery of brain metastases to the occurrence of meningeal metastases in 63 patients with brain metastases from non-small cell lung cancer with meningeal metastases was 12 months,with a 95％confidence interval of 7.139-16.861.Conclusion EGFR mutation is a high risk factor for meningeal metastasis in patients with non-small cell lung cancer brain metastasis.For pa-tients with brain and meningeal metastasis of non-small cell lung cancer,intrathecal chemotherapy on the basis of comprehensive treatment is a promising treatment.
万方数据
维普
