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recursive partitioning analysis Classification and Graded Prognostic Assessment for Non-Small Cell Lung Cancer Patients with Brain Metastasis:A Retrospective Cohort Study

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Chinese Journal of Cancer Research 2011年第3期23卷 177-182页

作者： Cai-xing Sun Tao Li Xiao Zheng Ju-fen Cai Xu-li Meng Hong-jian Yang Zheng Wang Zhejiang Traditional Chinese Medicine University Hangzhou 310053 China Department of Neurooncology Hangzhou 310022 China Department of Radiation Oncology Hangzhou 310022 China Department of Medical Oncology Zhejiang Cancer Hospital Hangzhou 310022 China Zhejiang People＇s Hospital Hangzhou 310024 China

Objective：To assess prognostic factors and validate the effectiveness of recursive partitioning analysis （RPA） classes and graded prognostic assessment （GPA） in 290 non-small cell lung cancer （NSCLC） patients with brain metastasis （BM）.Methods：From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors （TKIs） in two institutes were *** was estimated by Kaplan-Meier *** differences of survival rates in subgroups were assayed using log-rank *** Cox＇s regression method was used to analyze the impact of prognostic factors on *** prognostic indexes models （RPA and GPA） were validated ***：All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval （95% CI） was 14 （12.3-15.8） months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,*** survival curves of subgroups,stratified by both RPA and GPA,were significantly different （P0.001）.In the multivariate analysis as RPA and GPA entered Cox＇s regression model,Karnofsky performance status （KPS） ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic ***：KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.

关键词： Non-small cell lung cancer (NSCLC) Brain metastasis Prognosis recursive partitioning analysis Graded prognostic assessment

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Role of recursive partitioning analysis and Graded Prognostic Assessment on Identifying Non-Small Cell Lung Cancer Patients with Brain Metastases Who May Benefit from Postradiation Systemic Therapy

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Chinese Medical Journal 2018年第10期131卷 1206-1213页

作者： Shuai Liu Peng Chen Yan-Wei Liu Xue-Nan GU Xiao-Guang Qiu Bo Li Department of Radiation Oncology BeijLng Tiantan Hospital Capital Medical University Beijing 100050 China Department of Thoracic Oncology Tianjin Medical University Cancer Institute and Hospital Tianjin 300060 China

Background：The role ofpostradiation systemic therapy in non-small cell lung cancer （NSCLC） patients with brain metastasis （BM） was ***,we explored the role of Radiation Therapy Oncology Group recursive partitioning analysis （RTOG-RPA） and graded prognostic assessment （GPA） in identifying population who may benefit from postradiation systemic ***：The clinical data of NSCLC patients with documented BM from August 2007 to April 2015 of two hospitals were studied *** regression was used for multivariate *** of patients with or without postradiation systemic therapy was compared in subgroups stratified according to RTOG-RPA or ***：Of 216 included patients,67.1% received stereotactic radiosurgery （SRS）,24.1% received whole-brain radiation therapy （WBRT）,and 8.8% received *** radiotherapy,systemic therapy was administered in 58.3% of *** analysis found that postradiation systemic therapy （yes ***）（hazard ratio [HR] =0.36 l,95% confidence interval [CI] =0.202-0.648,P =0.001）,radiation technique （SRS ***）（HR =0.462,95% CI =0.238-0.849,P =0.022）,extracranial metastasis （yes ***）（HR =3.970,95% CI =1.757-8.970,P =0.001）,and Kamofsky performance status （〈70 vs.≥70）（HR =5.338,95% CI =2.829-10.072,P 〈 0.001） were independent factors for *** analysis found that subsequent tyrosine kinase inhibitor （TKI） therapy could significantly reduce the risk of mortality of patients in RTOG-RPA Class IⅡ （HR =0.411,95% CI =0.183-）.923,P =0.031） or with a GPA score of 1.5-2.5 （HR =0.420,95% CI =0.182-0.968,P =0.042）.However,none of the subgroups stratified according to RTOG-RPA or GPA benefited from the additional conventional ***：RTOG-RPA and GPA may be useful to identify beneficial populations in NSCLC patients with BM ifTKIs were chosen as postradiation systemic therapy.

关键词： Chemotherapy Non-Small Cell Lung Cancer recursive partitioning analysis Stereotactic Radiosurgery Tyrosine Kinase Inhibitors Whole-Brain Radiation Therapy

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