Characteristics of long-term survivors of brain metastases from lung cancer

Abstract

Background and aim

Long-term survival of lung cancer patients with brain metastases (BM) is very rare. Our aim is to report the characteristics of patients who survived for at least three years after a BM diagnosis.

Materials and methods

Nineteen lung cancer patients who had survived ≥3 years after a BM diagnosis were identified in our database. Seven (37%) had undergone whole-brain radiotherapy (WBRT) only, five (26%) BM surgery[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]WBRT, three (16%) BM surgery[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]WBRT[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]BM radiosurgery, and four (21%) no WBRT (one, surgery; one, radiosurgery; two, BM surgery[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]radiosurgery). Their characteristics were compared with historical data for 322 lung cancer patients with BM (control group, CG), who had received WBRT between 1986 and 1997.

Results

Median survival from BM in long survivors group was 73 months (in CG – 4 months). Characteristics comparison: median age 55 vs. 58 (CG), p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.16; female sex 68% vs. 28% (CG), p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.003; RTOG/RPA class 1 – 75% vs. 13% (CG), p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.00001; adenocarcinoma histology 84% vs. 24% (CG), p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.00001; control of primary tumor 95% vs. 27% (CG), p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.00001; extracranial metastases 0 vs. 26% (CG), p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.01; single BM 63% vs. 9% (CG), p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.00001; surgery of BM 53% vs. 14% (CG), p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.00001.

Conclusions

Beside prognostic factors already recognized as favorable in patients with BM, the adenocarcinoma histology and female sex were prevalent in long-term survivors of BM from lung cancer.