Clinical characteristics, treatment, and outcome of patients with large cell neuroendocrine carcinoma of the lung and brain metastases – data from a tertiary care center

IF 4.2 3区 医学 Q2 ONCOLOGY
Petar Popov, Ariane Steindl, Ladislaia Wolff, Elisabeth S. Bergen, Franziska Eckert, Josa M Frischer, Georg Widhalm, Thorsten Fuereder, Markus Raderer, Anna S. Berghoff, Matthias Preusser, Barbara Kiesewetter
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Abstract

Large cell neuroendocrine carcinoma (LCNEC) of the lung is an aggressive malignancy, with brain metastases (BM) occurring in approximately 20% of cases. There are currently no therapy guidelines for this population as only few data on the management of LCNEC and BM have been published. For this retrospective single center study, patients with LCNEC and BM were identified from the Vienna Brain Metastasis Registry. Data on clinicopathological features, BM-specific characteristics, treatment, and outcome were extracted. In total, 52/6083 (0.09%) patients in the dataset had a diagnosis of LCNEC and radiologically verified BM. Median age at diagnosis of LCNEC and BM was 59.1 and 60.1 years, respectively. Twenty-seven (51.9%) presented with single BM, while 12 (23%) exhibited > 3 BM initially. Neurologic symptoms due to BM were present in n = 40 (76.9%), encompassing neurologic deficits (n = 24), increased intracranial pressure (n = 18), and seizures (n = 6). Initial treatment of BM was resection (n = 13), whole brain radiation therapy (n = 19), and/or stereotactic radiosurgery (n = 25). Median overall survival (mOS) from LCNEC diagnosis was 16 months, and mOS after BM diagnosis was 7 months. Patients with synchronous BM had reduced mOS from LCNEC diagnosis versus patients with metachronous BM (11 versus 27 months, p = 0.003). Median OS after BM diagnosis did not differ between LCNEC patients and a control group of small cell lung cancer patients with BM (7 versus 6 months, p = 0.17). Patients with LCNEC and BM have a poor prognosis, particularly when synchronous BM are present. Prospective trials are required to define optimal therapeutic algorithms.

Abstract Image

肺大细胞神经内分泌癌脑转移患者的临床特征、治疗和预后--来自一家三级医疗中心的数据
肺大细胞神经内分泌癌(LCNEC)是一种侵袭性恶性肿瘤,约20%的病例会发生脑转移(BM)。目前还没有针对这一人群的治疗指南,因为有关 LCNEC 和 BM 治疗的数据很少。在这项回顾性单中心研究中,我们从维也纳脑转移登记处找到了LCNEC和脑转移患者。研究提取了临床病理特征、BM特异性特征、治疗和预后数据。数据集中共有52/6083(0.09%)例患者确诊为LCNEC和经放射学证实的BM。确诊 LCNEC 和 BM 的中位年龄分别为 59.1 岁和 60.1 岁。27名患者(51.9%)表现为单个BM,12名患者(23%)最初表现为> 3个BM。有 40 例(76.9%)患者因 BM 而出现神经系统症状,包括神经功能缺损(24 例)、颅内压增高(18 例)和癫痫发作(6 例)。BM的初始治疗为切除术(13例)、全脑放疗(19例)和/或立体定向放射手术(25例)。LCNEC确诊后的中位总生存期(mOS)为16个月,BM确诊后的中位总生存期为7个月。同步性骨髓瘤患者与间变性骨髓瘤患者相比,LCNEC确诊后的中位生存期缩短(11个月对27个月,P = 0.003)。LCNEC患者与对照组小细胞肺癌患者确诊BM后的中位OS没有差异(7个月对6个月,p = 0.17)。LCNEC和BM患者的预后较差,尤其是出现同步BM时。需要进行前瞻性试验来确定最佳治疗方案。
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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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