Brain metastasis (BM) was a common complication of patient with non-small cell lung cancer (NSCLC) and associated with a poor prognosis. The study was to evaluate the effect of cerebral infarction (CI) which was originated from cancer emboli on the risk of BM in NSCLC for preventive therapy strategy. Methods Three hundred seven patients with newly diagnosed NSCLC in our institute from July 2013 to July 2018 were retrospectively analyzed. The diagnostic criteria of CI refereed to Updated Criteria for Population-Based Stroke and Transient Ischemic Attack Incidence Studies for the 21st Century. Depending on magnetic resonance imaging (MRI), the patients were divided into the BM group and control group (without BM). Then, the prevalence of CI and baseline clinicopathological parameters were evaluated and compared between the two groups. Results Of the 307 patients, 204 patients (66.4%) had CI and 52 patients (16.9%) had BM. Especially, the prevalence of CI in the NSCLC patients with BM was 84.6%, which was significantly higher than that of 62.7% in the NSCLC patients without BM (p = 0.002). Following univariate logistic regression analysis and the multivariate model, the results demonstrated that CI was a significant independent risk factor for BM in NSCLC (odds rate, 3.303; 95% confidence interval, 1.437-7.593; p = 0.005). What's more, CI contributed to a worse prognosis in NSCLC patients with BM. Dynamical trace confirmed CI could promote BM in NSCLC patient. Conclusions CI could be associated with a metastatic tropism to the brain and then with an increased risk of BM in NSCLC patient. Therefore, targeted intervention of the metastatic core of CI could offer promising approach for the prevention, prognostic evaluation, and therapy of BM in NSCLC patients for better clinical outcome.

BackgroundAs patients with brain metastasis (BM) of non-small cell lung cancer (NSCLC) have dismal prognosis, some of them decide to discontinue further treatment for BM. The objective of this study was to determine factors for renouncing further active therapy in patients with BM of NSCLC, focusing on their demographic and socioeconomic status.MethodsMedical records of 105 patients with radiological diagnosis of BM of NSCLC for the recent 11 years at authors' institution were retrospectively reviewed. Clinical features as well as demographic and socioeconomic characteristics such as marriage status, cohabiting family members, religious affiliations, educational background, and economic responsibility were reviewed.ResultsMedian overall survival (OS) was 13.84 (95% CI: 10.26–17.42) years in 67 patients (group A) who underwent active treatment (radiotherapy and/or chemotherapy) and 4.76 (95% CI: 3.12–6.41) years in 38 patients (group B) who renounced active treatment. Less patients were unmarried (p=0.046), more cohabitating family members (p=0.008), and economically independent (p=0.014) in group A than those in group B. Similarly, the unmarried, and none cohabitating family members had short OS (5.17 and 7.38 years, respectively). In multivariate analysis for predisposing factors of OS in these patients, the following demographic and socioeconomic factors had independent significance: marriage status and cohabitating family members.ConclusionThis study suggests that demographic and socioeconomic status as well as clinical factors could influence the decision of further active treatment and prognosis of patients with BM of NSCLC.