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. 2022 Dec 26;12(1):22372.
doi: 10.1038/s41598-022-26131-z.

Brain parenchymal and leptomeningeal metastasis in non-small cell lung cancer

Qing Li #  1 , Zhen Lin #  1 , Ye Hong  1 , Yang Fu  1 , Yueyun Chen  1 , Ting Liu  1 , Yue Zheng  1 , Jiangfang Tian  1 , Chunhua Liu  1 , Wei Pu  1 , Zhenyu Ding  1 , Chun Wang  2
Affiliations

Brain parenchymal and leptomeningeal metastasis in non-small cell lung cancer

Qing Li et al. Sci Rep. .

Abstract

Patients with advanced non-small cell lung cancer (NSCLC) are prone to brain metastases (BM), which essentially include brain parenchymal metastases (PM) and leptomeningeal metastases (LM). We conducted a retrospective study to comprehensively assess the clinical characteristics and risk factors of patients with advanced NSCLC who develop PM and LM. Patients with advanced NSCLC were enrolled. These patients were then divided into three groups for analysis: patients without BM (No-BM), patients with PM and patients with LM. Data on clinical characteristics of each patient at the time of diagnosis advanced NSCLC were extracted and analyzed. In addition, prediction models were developed and evaluated for PM and LM. A total of 592 patients were enrolled in the study. BM was present in 287 patients (48.5%). Among them, 185 and 102 patients had PM or LM. Patients with LM had a higher proportion of EGFR exon 21point mutations (L858R) compared to patients with No-BM and PM (p < 0.0001). The median time to the onset of PM and LM from the diagnosis of advanced NSCLC was 0 months and 8.3 months, respectively. Patients with LM had a statistically shorter over survival (OS) compared to either No-BM or PM patients (p < 0.0001). Based on independent predictive variables, two nomogram models were constructed to predict the development of PM and LM in advanced NSCLC patients, and the C-indexes were 0.656 and 0.767, respectively. Although both considered as BM, PM and LM had different clinical characteristics. And the nomogram showed good performance in predicting LM development, but not PM.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Baseline characteristics. *p < 0.05, **p < 0.01, ****p < 0.0001.
Figure 3
Figure 3
The time of PM and LM onset. The swimming plot from the diagnosis of advanced NSCLC to the onset of PM (a) or LM (b) and eventually to death or censorship. Summary of the onset of PM or LM during the clinical course of advanced NSCLC (c). The swimming plot of the patients with both LM and PM (d).
Figure 4
Figure 4
Metastatic sites. The summary of metastatic sites in patients with No-BM (a), PM (b) and LM (c).
Figure 5
Figure 5
Survival. The survival curves calculated from the diagnosis of advanced NSCLC (a). The survival curves calculated from the diagnosis of PM and LM (b).
Figure 6
Figure 6
Nomogram for the prediction of PM (a) and LM (b).
Figure 7
Figure 7
Receiver operating characteristic (ROC) curves (a,e), calibration curves (b,f), decision curve analysis (DCA, c,g) and clinical impact plots of nomogram (d,h) for predicting PM and LM.
See this image and copyright information in PMC

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