Avtor/Urednik		Smrdel, Uroš; Zwitter, Matjaž; Kovač, Viljem
Naslov		Brain metastases in lung cancer. Impact of prognostic factors on patient survival
Prevedeni naslov		Možganske metastaze pri bolnikih s pljučnim rakom. Vpliv prognostičnih dejavnikov na preživetje
Tip		članek
Vir		Radiol Oncol
Vol. in št.		Letnik 37, št. 4
Leto izdaje		2003
Obseg		str. 213-6
Jezik		eng
Abstrakt		Background. Brain metastases are common patterns of dissemination in lung cancer patients. In this paper we would like to assess the pattern of brain metastases in lung cancer patients and the impact of prognostic factors on the survival of lung cancer patients with brain metastases. Patients and methods. In the year 1998 there were 974 registered patients with lung cancer in Slovenia, six hundred and fifteen of them were treated at the Institute of Oncology Ljubljana and we analyzed them. Among 615 patients 137 (22.3%) of them have had brain metastases during a natural course of disease. Results. For 12 patients presenting with solitary brain metastases (most of them were undertaken metastaseetomy) median survival was 7.6 months, while in patients with multiple brain metastases the median survival was 2.8 months (p = 0.0018). Of the 137 patients 45 (32.8%) were small cell lung cancer patients, 43 (31.4%) were adenocarcinoma patients and 19 (13.9%) were squamous cell carcinoma patients. Patients with performance status (WHO scale) less than 2 had the median survival time 3.7 months while patients with performance status 2 or more had median survival time 2.7 moths (p=0.0448). Conclusions. Patients with solitary brain metastases had better survival comparing with those who had multiple metastases. It is surprisingly that the portion of brain metastases patients with adenocarcinoma is almost equal to those with small-call lung cancer therefore, the prophylactic cranial radiation becomes actual for both groups of patients. The performance status of patients with brain metastases remains very important prognostic factor.
Izvleček		Izhodišča. Pljučni rak pogosto zaseva v možgane. V prispevku smo ugotavljali, pri katerih bolnikih s pljučnim rakom se pojavljajo možganske metastaze in kako različni napovedni dejavniki vplivajo na preživetje bolnikov. Bolniki in metode. V letu 1998 je bilo v Sloveniji ugotovljenih 974 novih bolnikov s pljučnim rakom, 615 med njimi je bilo obravnavanih tudi na Onkološkem inštitutu v Ljubljani. Med potekom bolezni smo pri 137 (22,3%) od 615 bolnikov odkrili možganske metastaze. Rezultati. Srednje preživetje pri 12 bolnikih s solitarnimi možganskimi metastazami (pri večini je bila narejena metastazektomija) je bilo 7,6 mesecev, srednje preživetje pri bolnikih z multiplimi možganskimi metastazami pa je bilo 2,8 meseca (p = 0.0018). Od 137 bolnikov jih je 45 (32,8%) imelo drobnocelični pljučni rak, 43 (31,4%) žlezni rak in 19 (13,9%) skvamoznocelični pljučni rak. Bolniki, ki so imeli stanje splošne zmogljivosti po WHOju manj kot 2, so imeli srednje preživetje 3,7 meseca, bolniki s stanjem splošne zmogljivosti 2 ali več pa 2,7 meseca (p=0.0448). Zaključki. Bolniki s solitarnimi možganskimi metastazami imajo statistično značilno boljše preživetje kot tisti z multiplimi možganskimi metastazami. Preseneča velik odstotek bolnikov z žleznim pljučnim rakom, pri katerih odkrivamo možganske metastaze skoraj v enakem odstotku kot pri bolnikih z drobnoceličnim pljučnim rakom. Tako moramo ponovno razmisliti, all ni indicirano profilaktično obsevanje glave tudi pri bolnikih z žleznim pljučnim rakom? Tudi pri naših bolnikih se je pokazalo, da je stanje splošne zmogljivosti odločilen napovedni dejavnik za preživetje.
Deskriptorji		LUNG NEOPLASMS NEOPLASM METASTASIS BRAIN NEOPLASMS SURVIVAL ANALYSIS