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. 2019 Dec 10:9:1352.
doi: 10.3389/fonc.2019.01352. eCollection 2019.

Stereotactic Radiation Therapy (SRT) for Brain Metastases of Multiple Primary Tumors: A Single Institution Retrospective Analysis

Lei Gu  1 , Shuiwang Qing  1 , Xiaofei Zhu  1 , Xiaoping Ju  1 , Yangsen Cao  1 , Zhen Jia  1 , Yuxin Shen  1 , Fei Cao  1 , Fang Fang  1 , Huojun Zhang  1
Affiliations

Stereotactic Radiation Therapy (SRT) for Brain Metastases of Multiple Primary Tumors: A Single Institution Retrospective Analysis

Lei Gu et al. Front Oncol. .

Abstract

Purpose: To evaluate the efficiency and side effects of stereotactic radiation therapy (SRT) with or without other treatments for brain metastases (BM) from various primary tumors. Methods: This was a retrospective analysis of 161 patients with brain metastases treated with SRT. Clinical data, EGFR mutation status and survival data were collected. Follow-up data was analyzed until December 2018. Kaplan-Meier and Cox proportional hazards regression analyses were used for the survival analysis. Results: The median overall survival (OS) was 19 months. No difference was observed in OS between SRT group and SRT + whole brain radiation therapy (WBRT) groups (p = 0.717). Statistically significant factors of better OS after univariable analysis were no extracranial metastases (p = 0.016), BED10-SRT≥50Gy (p = 0.049), oligometastases (1-3 brain metastases) (p < 0.001), GPA score≥2.5 (p = 0.003), RPA class I (p = 0.026), NSCLC tumor type (p = 0.006), targeted therapy (p < 0.001) and controlled extracranial disease (p = 0.011). Multivariate analysis indicated that higher BED10-SRT (≥50Gy, HR = 0.504, p = 0.027), controlled extracranial disease (HR = 0.658, p = 0.039) and targeted therapy (HR = 0.157, <0.001) were independent favorable predictors for OS. Besides that, we also find that the median overall survival (OS) was 22 months in NSCLC patients and controlled extracranial disease (HR = 0.512, p = 0.012) and targeted therapy (HR = 0.168, < 0.001) were independent favorable predictors for OS. Conclusion: For patients with brain metastases, stable extracranial disease, higher BED10-SRT (≥50Gy) and targeted therapy may predict a favorable prognosis.

Keywords: brain metastasis; non–small-cell lung cancer; overall survival; prognostic factors; stereotactic radiation therapy.

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Figures

Figure 1
Figure 1
Overall survival of all 161 patients after SRT.
Figure 2
Figure 2
Overall survival of patients with BED ≥ 50 Gy and BED < 50 Gy (p = 0.027).
Figure 3
Figure 3
Overall survival of patients with targeted therapy and no targeted therapy (p < 0.001).
Figure 4
Figure 4
Overall survival of patients with extracranial disease controlled and uncontrolled (p = 0.039).
Figure 5
Figure 5
Overall survival of NSCLC patients after SRT.
Figure 6
Figure 6
Overall survival of NSCLC patients with extracranial disease controlled and uncontrolled (p = 0.012).
Figure 7
Figure 7
Overall survival of NSCLC patients with targeted therapy and no targeted therapy (p < 0.001).
See this image and copyright information in PMC

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