Survival prognostic factors for patients with synchronous brain oligometastatic non-small-cell lung carcinoma receiving local therapy

Abstract

Introduction: Clinical evidence for patients with synchronous brain oligometastatic non-small-cell lung carcinoma is limited. We aimed to summarize the clinical data of these patients to explore the survival prognostic factors for this population. Methods: From September 1995 to July 2011, patients with 1-3 synchronous brain oligometastases, who were treated with stereotactic radiosurgery (SRS) or surgical resection as the primary treatment, were identified at Shanghai Chest Hospital. Results: A total of 76 patients (22 patients underwent brain surgery as primary treatment and 54 patients received SRS) were available for survival analysis. The overall survival (OS) for patients treated with SRS and brain surgery as the primary treatment were 12.6 months (95% confidence interval [CI] 10.3-14.9) and 16.4 months (95% CI 8.8-24.1), respectively (adjusted hazard ratio =0.59, 95% CI 0.33-1.07, P=0.08). Among 76 patients treated with SRS or brain surgery, 21 patients who underwent primary tumor resection did not experience a significantly improved OS (16.4 months, 95% CI 9.6-23.2), compared with those who did not undergo resection (11.9 months, 95% CI 9.7-14.0; adjusted hazard ratio =0.81, 95% CI 0.46-1.44, P=0.46). Factors associated with survival benefits included stage I-II of primary lung tumor and solitary brain metastasis. Conclusion: There was no significant difference in OS for patients with synchronous brain oligometastasis receiving SRS or surgical resection. Among this population, the number of brain metastases and stage of primary lung disease were the factors associated with a survival benefit.