To investigate the clinical features of patients with driver gene-positive lung adenocarcinoma complicated with bone metastases and the influence of changes in bone metastases on prognosis after antitumor therapy.

According to the inclusion and exclusion criteria, the data of 56 patients with driving-gene positive lung adenocarcinoma complicated with bone metastasis admitted to Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2017 to March 2023 were obtained, and their clinical, pathological and imaging characteristics were analyzed. Kaplan-Meier method was used to analyze the effects of enlarged osteogenic lesions or new osteogenic lesions on patients′ prognosis.

Among the 56 patients enrolled, 11 patients (20%) had pathological fractures, 3 patients (5%) had spinal cord compression, 10 patients (18%) received radiotherapy for bone metastases, and 9 patients (16%) received bone metastases surgery. All of these were patients with osteolytic or mixed bone metastases. The median progression-free survival for all patients was 13.6 months (95%CI was 10.3-16.9 months). 20% (11/56) patients had enlarged osteogenic lesions or new osteogenic lesions. The median progression-free survival was 37.7 months (95%CI was 5.4-70.0 months) in patients with enlarged osteogenic lesions or new osteogenic lesions, while the median progression-free survival was 13.1 months (95%CI was 9.3-16.9 months) in patients without enlarged osteogenic lesions or new osteogenic lesions (χ²=4.141, P=0.0418).

The patients with enlarged osteogenic lesions or new osteogenic lesions after targeted therapy of driver gene-positive lung adenocarcinoma have obvious survival benefits compared with patients without enlarged osteogenic lesions or new osteogenic lesions.

Lung adenocarcinoma; Bone metastasis; Prognosis