Treatment and Prognosis of Solid and Cystic Brain Metastases in Patients with Non-Small-Cell Lung Cancer

Figures & data

Table 1 Baseline Characteristics of 255 Patients with NSCLC with Solid Metastases and 33 Patients with NSCLC with Cystic Metastases

Characteristics	Cohort 1 (n=255)	Cohort 2 (n=33)	P value
Sex			0.870
Male	143(56.1%)	19 (57.6%)
Female	112(43.9%)	14 (42.4%)
Age, y			0.030
<65	188(73.7%)	30 (90.9%)
≥65	67(26.3%)	3(9.1%)
Smoking history			0.190
No	139(54.5%)	14 (42.4%)
Yes	116(45.5%)	19 (57.6%)
ECOG score			0.916
0–1	180(70.6%)	23 (69.7%)
≥2	75(29.4%)	10 (30.3%)
Histologic subtype			0.223
Squamous	34(13.3%)	7 (21.2%)
Adenocarcinoma	221(86.7%)	26 (78.8%)
Gene mutation status			0.846
EGFR mutation	149(58.4%)	16 (48.5%)
ALK positive	10(3.9%)	4 (12.1%)
Negative	96(37.7%)	13(39.4%)
Number of brain metastases			0.144
1	88(34.5%)	16 (48.5%)
2	44(17.3%)	7 (21.2%)
≥3	123(48.2%)	10 (30.3%)
Additional brain intervention			0.045
Yes	173(67.8%)	28(84.8%)
No	82(32.2%)	5 (15.2%)
TKI drugs treatment			0.723
Yes	100(39.2%)	14 (51.2%)
No	155(60.8%)	19 (48.8%)

Table 2 Baseline Characteristics of Patients According to Treatment Regimens in Cohort 2

	Targeted Treatment (n=14)	Chemotherapy Treatment (n=19)	P value
Sex			0.029
Male	5 (35.7%)	14 (73.7%)
Female	9 (64.3%)	5 (26.3%)
Age, y			0.561
<65	12 (85.7%)	18 (94.7%)
≥65	2 (14.3%)	1 (5.3%)
Smoking history			0.029
No	9 (64.3%)	5 (26.3%)
Yes	5 (35.7%)	14 (73.7%)
ECOG score			1.000
0–1	10 (71.4%)	13 (68.4%)
2	4 (28.6%)	6 (31.6%)
Histologic subtype			0.013
Squamous	0 (0%)	7 (36.8%)
Adenocarcinoma	14 (100.0%)	12 (63.2%)
Number of brain lesions			0.455
1–2	11 (78.6%)	12 (63.2%)
≥3	3 (21.4%)	7 (36.8%)
If brain radiotherapy			0.049
No	10 (71.4%)	7 (36.8%)
Yes	4 (28.6%)	12 (63.2%)
If anti-vascular drugs			0.561
No	12 (85.7%)	18 (94.7%)
Yes	2 (14.3%)	1 (5.3%)

Figure 1 The brain enhanced MRI of a 61-year-old woman with non-small cell lung cancer and EGFR 21L858R mutation before and after EGFR-TKI treatment. The positions indicated by the arrows are the lesions. (A) Contrast-enhanced T1-weighted MR image at baseline. (B) Contrast-enhanced T2-weighted MR image at baseline. (C) Contrast-enhanced T1-weighted MR image after icotinib (first-generation EGFR-TKI) treatment and whole brain radiotherapy (prescription dose and fraction schedule of 30Gy/10F) treatment for 1 month. (D) Contrast-enhanced T2-weighted MR image after icotinib and whole brain radiotherapy treatment for 1 month.

Figure 2 Kaplan–Meier estimates of progression-free survival with 33 patients in cohort 2, according to the different treatments: (A) Targeted drugs and chemotherapy treatment (12.6 months vs 6.3 months, P=0.001). (B) Median iPFS between targeted regimens and chemotherapy treatment (8.4 months vs 6.0 months, P=0.042).

Figure 3 Kaplan–Meier estimates of intracranial progression-free survival with all patients in two cohorts, according to different types of brain metastases. (A) Solid brain metastases and cystic brain metastases (15.4 months vs 9.9 months, P=0.015). (B) Median iPFS between solid brain metastases and cystic brain metastases without targeted therapy (11.7 months vs 6.5 months, P=0.003).

Figure 4 Kaplan–Meier estimates of overall survival in patients receiving targeted drugs, according to different types of brain metastases: solid brain metastases and cystic brain metastases (23.4 vs 47.9 months; P=0.013).

Figure 5 Kaplan–Meier estimates of overall survival according to different treatments in patients with cystic BM: targeted drugs and chemotherapy (47.9 months vs 17.0 months, P=0.007).