Efficacy and prognostic factors of bevacizumab combined with gamma knife for brain metastases of elderly patients with lung cancer
ZHANG Yanyan
LIU Jing
GUO Xiaojun
ZHAO Xinhan
WANG Binfeng
Abstract：Objective To investigate the efficacy and prognostic factors of bevacizumab combined with gamma knife in the treatment of brain metastases of elderly patients with lung cancer.Methods Case data of 178 elderly patients with lung cancer brain metastases treated in our hospital from September 2020 to September 2023 were retrospectively analyzed.The patients were divided into a control group(n=90)and a study group(n=88)according to the treatment methods.The control group received gamma knife treatment and conventional treatments such as dehydration and steroids after treatment.The study group received treatment with bevacizumab in addition to the control group's treatment.The treatment efficacy,Karnofsky functional status(KPS)score,National Institutes of Health Stroke Scale(NIHSS)score,immune function and toxic side effects of the two groups were analyzed.Univariate and multivariate Cox regression were made to explore the influencing factors of prognosis in elderly patients with lung cancer brain metastases.Results The objective remission rate and disease control rate of the control group were 52.22%(47/90)and 81.11%(73/90),which were lower than those of the study group(77.27%)(68/88)and 92.05%(81/88)(P<0.05).After treatment,the KPS scores of both groups of patients increased and the NIHSS scores decreased,and the above indicators in the study group were better than those in the control group(P<0.05).After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the two groups were increased,and the levels of the study group were higher(P<0.05).There was no significant difference in the total incidence of side effects between the two groups(P>0.05).The 1 year follow-up showed that a total of 125 patients survived,and the 1-year overall survival rate was 70.22%(125/178).The 1-year overall survival rate of elderly lung cancer patients with brain metastases was related to age,number of brain metastases,pathological types,treatment methods,primary disease control and cerebellar lesion involvement(all P<0.05).The 1-year overall survival rate of cases treated with bevacizumab combined with gamma knife was higher than that of patients treated with gamma knife only(P<0.05).The number of brain metastases(HR=2.563,95%CI:1.429-4.596),pathological type(HR=2.765,95%CI:1.674-4.567),treatment method(HR=2.298,95%CI:1.550-3.407),primary disease control(HR=2.171,95%CI:1.246-3.780),cerebellar lesion involvement(HR=2.010,95%CI:1.138-3.548)were the prognostic factors in elderly patients with lung cancer brain metastases(P<0.05).Conclusion Compared with the treatment of elderly lung cancer brain metastases only with gamma knife,the combination of bevacizumab and gamma knife has a better therapeutic effect,which can significantly improve the KPS score,NIHSS score,and immune level.The number of brain metastases,pathological type,treatment method,control of primary disease,and involvement of the cerebellum are key factors affecting the treatment prognosis of elderly lung cancer brain metastases.
Keywords：bevacizumabgamma knifelung cancer brain metastaseselderly patientscurative effectprognosis
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：6( 91-96 )