Risk factors of brain metastasis of lung squamous cell carcinoma: a retrospective analysis of 188 patients from single center

Background: To explore risk factors and the efficacy of treatment strategies for brain metastasis (BM) in squamous cell carcinoma (SCC) of the lung. Methods: The clinical data of 188 pathologically confirmed as squamous cell carcinoma or adenosquamous carcinoma patients were studied retrospectively. Factors including age (<60 vs. ≥60), gender, stage at diagnosis, T status (T1–2 vs. T3–4), N status (N0–1 vs. N2–3), histology (squamous vs. adenosquamous), smoking history (non-smoker vs. current smoker) and serum tumor markers (normal vs. elevated) were analyzed. Results: The incidence of BM was 19.1% (36/188) in our cohort. Patients who were female (p = 0.005), had advanced disease at diagnosis (p < 0.001), had adenosquamous carcinoma histology (p = 0.033) or had elevated serum level of CEA at diagnosis (p < 0.001) had significantly higher incidence of BM. In multivariate analysis, female (p = 0.034, HR = 18.874) and elevated serum level of CEA at diagnosis (p = 0.009, HR = 19.824) were independent risk factors of BM. BM patients who received additional systemic therapy after local therapy had significantly longer post-BM survival than those who received local therapy only (p = 0.004, HR = 0.058). Gemcitabine/platinum-containing regimen (GP) and taxans/platinum-containing regimen (TP) led to comparable brain-metastasis-free survival (BMFS) (p = 0.10). Conclusions: Females and patients with elevated serum level of CEA at diagnosis had a higher risk of developing BM. The following systemic therapy after local therapy prolonged the survival of BM patient, but the efficacy of GP and TP was comparable in terms of preventing BM.