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首页> 外文期刊>International journal of colorectal disease. >Brain metastases from colorectal cancer: Main clinical factors conditioning outcome
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Brain metastases from colorectal cancer: Main clinical factors conditioning outcome

机译：大肠癌的脑转移：主要临床因素调节结局

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Background: The aim of our study is to evaluate the outcome of patients affected by brain metastases from colorectal cancer and to correlate the outcome with prognostic factors. Methods: Patients were retrospectively evaluated. Survival distributions were estimated by using the Kaplan-Meier method. The log-rank test was used to assess the impact on survival of individual factors. Results: Among 41 patients (25M and 16F; median age 58), 58.5 % had rectal cancer and 39 % synchronous metastatic disease; 95 % had extracranial metastases, most common site was lung (87.8 %). Seven patients had synchronous brain metastases. Median overall survival after diagnosis of brain metastases was 5 months [95 % confidence interval 3-12 months]. Median survival from brain metastases diagnosis was 4.2 months in patients treated with radiotherapy (29.3 %), 11.9 months in those with radio- and chemotherapy (21.9 %) and 21.4 months in those with surgery with/without radiotherapy or chemotherapy (29.3 %) (P < 0.0001). On multivariate analysis, no independent prognostic factors were found for disease-free interval from diagnosis to brain metastases and overall survival; amount of chemotherapy before brain metastases have no statistically significant relation to brain-metastases-free-interval even if patients who received more than one line of chemotherapy have a longer median brain-metastases-free-interval than those who received less than one. KRAS was found mutated in 17/28 patients without statistically significant correlation to outcome due to the small sample size. Conclusions: Prognosis of brain-metastases-patients is poor. An interesting tool is to evaluate the correlation of KRAS status and brain metastases with aim to tailor treatment and follow-up.
机译：背景：我们研究的目的是评估结直肠癌脑转移患者的预后，并将预后与预后相关联。方法：对患者进行回顾性评估。生存分布通过使用Kaplan-Meier方法进行估计。使用对数秩检验来评估对单个因素生存的影响。结果：41例患者（25M和16F;中位年龄58岁）中，有58.5％患有直肠癌，39％患有同步转移性疾病; 95％有颅外转移，最常见的部位是肺（87.8％）。七例患者出现同步性脑转移。诊断为脑转移后的总体生存中位数为5个月[95％置信区间3-12个月]。在接受放射治疗的患者中，脑转移瘤诊断的中位生存期为4.2个月（29.3％），接受放射和化学疗法的患者为11.9个月（21.9％），接受/不接受放射治疗或化学疗法的患者为21.4个月（29.3％）（ P <0.0001）。在多变量分析中，没有发现独立的预后因素，即从诊断到脑转移和总体生存的无疾病间隔。即使接受多于一系化学疗法的患者比未接受一系化学疗法的患者具有更长的中位无脑转移的中位数，脑转移前化疗的量与无脑转移的统计学意义无统计学意义。由于样本量小，在17/28例患者中发现KRAS突变与预后没有统计学显着相关性。结论：脑转移患者的预后较差。一个有趣的工具是评估KRAS状态与脑转移的相关性，以量身定制治疗和随访方法。

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