The role of brain metastases in patients with pulmonary adenocarcinoma: a retrospective study.

Background: Brain metastasis is common in patients with lung cancer and has a negative impact on overall survival (OS). The aim of this study was to investigate therapeutic effects and prognosis-related factors for survival of patients with pulmonary adenocarcinoma and brain metastasis.

Methods: This was a retrospective study involving the data of patients with pulmonary adenocarcinoma and brain metastasis who were treated at the Department of Oncology, Tianjin Medical University General Hospital. Participants were divided into 2 groups: the initial-metastasis group (brain metastases at first visit), and the late-metastasis group (developed metastasis during treatment). The quantitative index was described as mean ± standard deviation (SD), independent sample t-test was used to calculate the P value. All data were processed using the software SPSS 20.0 software package.

Results: There were a total of 43 patients in the initial-metastasis group and 49 in the late-metastasis group. First-line treatment efficacy (P=0.004), OS (P<0.001), and progression-free survival (PFS) (P=0.006) were higher in the late-metastasis group. Kaplan-Meier curves revealed that the late-metastasis group had longer OS, intracranial progression-free survival (IPFS), and PFS (all P<0.001). Multivariate analysis showed that gender, Karnofsky performance status (KPS), efficacy of first-line treatment, radiotherapy, and brain metastasis at initial visit were significantly related to OS.

Conclusions: Participants with pulmonary adenocarcinoma and brain metastasis at their initial visit had shorter OS and PFS than those who developed brain metastasis later. The efficacy of first-line treatment was related to OS while female gender and high KPS score were protective factors.