Abstract
Introduction
Metastasis to intraocular structures is a serious problem in lung cancer. Due to its
rarity, however, limited information is available regarding the outcomes of treatment
and prognosis. Literature often suggests a poor prognosis. We review current literature
on the outcomes of systemic therapy and prognostic factors.
Methods
We conducted a systematic review of English literature published during 2009 to 2022
identified via Medline and Google Scholar search. Publications reporting on tumor
response in the eyes or overall survival of patients with intraocular metastasis due
to lung cancer were included. Pooled analysis of patients receiving systemic therapy
was performed, utilizing individual-level patient data.
Results
A total of 79 publications contributed 92 patients into the analysis. Choroid was
the most affected intraocular structure, in 82% of patients. Histology was small cell
in 13% and non-small cell in 87%. Targeted therapy was utilized in 45% of patients.
A pooled analysis demonstrated that the median overall survival was 27 months (95%
CI: 21.8-32.2). Visual response among those with reported assessment showed that 92%
of them had stable or improved vision while 8% experienced worsening of vision. Several
factors including the year of treatment, age, targeted therapy, and radiation showed
a significant association with survival. The strongest predictor of improved survival
was the receipt of targeted therapy, with a hazard ratio of 0.31 (95% CI: 0.14-0.71),
P = .005.
Conclusions
For lung cancer patients with intraocular metastasis, systemic therapy can produce
a favorable outcome. Particularly when a targeted therapy is feasible, long-term survival
can be achieved.
Keywords
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Article info
Publication history
Published online: August 06, 2022
Accepted:
July 24,
2022
Received in revised form:
July 19,
2022
Received:
April 19,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
