Jale KARAKAYA, Ahmet Selim YURDAKUL, Dursun TATAR, Hüseyin HALİLÇOLAR, Can ÖZTÜRK

Beyin metastazı bulunan primer akciğer kanserli hastalarda prognozu etkileyen faktörler

Beyin metastazları, akciğer kanserli hastalarda hastalık süresince sık görülen bir durumdur. Bu çalışmanın amacı; beyin metastazlı akciğer kanserli hastalarda prognostik faktörleri araştırmaktır. Çalışmaya beyin metastazı olan 88 akciğer kanserli hasta alındı. Olguların 82’si erkek, 6’sı kadındı ve yaş ortalaması 57.5 ± 10.4 yıldı. En sık görülen nörolojik semptomlar baş ağrısı (%32.9) ve baş dönmesi (%32.9) idi. Elliiki (%59.1) hastada soliter beyin metastazı mevcuttu ve en sık metastaz lokalizasyonu pariyetal lobdu. Akciğer kanseri tanısından sonra ortanca sağkalım süresi üç ay, beyin metastazından sonra ise 1.5 ay olarak bulundu. Akciğer kanseri tanısı sonrası sağkalımda etkisi bulunan iyi prognostik faktörler tanı anında beyin metastazı olmaması, metakron metastaz, tümörün santral yerleşimi, kemoterapi uygulanımı ve beyin metastazının cerrahi tedavisi iken, beyin metastazı sonrası sağkalımda etkili olumlu faktörler tümörün santral yerleşimi, kemoterapi uygulanımı ve beyin metastazının cerrahi tedavisiydi. Sonuç olarak, beyin metastazı olan tüm uygun akciğer kanserli hastalarda kranial radyoterapi, kemoterapi, cerrahi tedavi ve destek tedavisi kombinasyonlarının uygulanımı değerlendirilmelidir.

Factors affecting the prognosis in patients with primary lung cancer and brain metastases

Brain metastases are frequent features during the course of patients with lung carcinoma. The aim of this study was to investigate prognostic factors for patients with brain metastasis from lung cancer. Eighty-eight patients with brain metastasis from lung cancer were enrolled in the study. Eighty-two of cases were male, six were female and the mean age was 57.5 ± 10.4 years. The most common symptoms were headache (32.9%) and dizziness (32.9%). Fifty-two (59.1%) patients had solitary brain metastasis and the most frequent metastasing site was parietal lobe (34.1%). The median survival times were 3 months after diagnosis of lung carcinoma and 1.5 months after diagnosis of brain metastasis. Although the absence of brain metastasis at the moment of diagnosis, metachronous metastasis, santral localization of the tumour, chemotherapy administration and surgical treatment of brain metastasis are good prognostic factors affecting survival after the diagnosis of lung carcinoma, the positive factors affecting survival after brain metastasis are santral localization of tumour, chemotherapy administration and surgical treatment of brain metastasis. In conclusion, performing the combination of cranial radiotherapy, chemotherapy, surgical therapy and supporting therapy should be evaluated in all appropriate patients with brain metastasis from lung cancer.

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