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. 2021 Apr 13;11(1):8046.
doi: 10.1038/s41598-021-87357-x.

Radiotherapy for brain metastasis and long-term survival

Kawngwoo Park #  1 , Gi Hwan Bae #  2   3 , Woo Kyung Kim  1 , Chan-Jong Yoo  1 , Cheol Wan Park  4 , Soo-Ki Kim  5 , Jihye Cha  6 , Jin Wook Kim  7 , Jaehun Jung  8   9
Affiliations

Radiotherapy for brain metastasis and long-term survival

Kawngwoo Park et al. Sci Rep. .

Abstract

Patients with brain metastases (BM) can benefit from radiotherapy (RT), although the long-term benefits of RT remain unclear. We searched a Korean national health insurance claims database and identified 135,740 patients with newly diagnosed BM during 2002-2017. Propensity score matching (PSM) was used to evaluate survival according to RT modality, which included whole-brain radiotherapy (WBRT) and/or stereotactic radiosurgery (SRS). The 84,986 eligible patients were followed for a median interval of 6.6 months, and 37,046 patients underwent RT (43.6%). After the PSM, patients who underwent RT had significantly better overall survival after 1 year (42.4% vs. 35.3%, P < 0.001), although there was no significant difference at 2.6 years, and patients who did not undergo RT had better survival after 5 years. Among patients with BM from lung cancer, RT was also associated with a survival difference after 1 year (57.3% vs. 32.8%, P < 0.001) and a median survival increase of 3.7 months. The 1-year overall survival rate was significantly better for SRS than for WBRT (46.4% vs. 38.8%, P < 0.001). Among Korean patients with BM, especially patients with primary lung cancer, RT improved the short-term survival rate, and SRS appears to be more useful than WBRT in this setting.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study flowchart. CNS central nervous system, WBRT whole-brain radiotherapy, SRS stereotactic radiosurgery. Created using R software (version 3.5.2; R Foundation for Statistical Computing, Vienna, Austria).
Figure 2
Figure 2
Kaplan–Meier survival curves according to radiotherapy (RT) status. Outcomes are shown as overall survival among all patients. Non-RT Non- radiotherapy, RT radiotherapy. Created using SAS software (version 9.4; SAS Institute Inc., Cray, NC, USA).
Figure 3
Figure 3
Cox regression survival analyses for lung cancer. Cox proportional hazards model adjusted for age, sex, CCI, chemotherapy use, surgery use, diagnostic year, and primary tumor location. HR hazard ratio, Non-RT Non-radiotherapy, RT radiotherapy. Created using SAS software (version 9.4; SAS Institute Inc., Cray, NC, USA).
Figure 4
Figure 4
Cox regression survival analyses for SRS only vs. WBRT (a), SRS only vs. SRS + WBRT (b), and WBRT vs. SRS + WBRT (c). Cox proportional hazards model adjusted for age, sex, CCI, chemotherapy use, surgery use, diagnostic year, and primary tumor location. WBRT whole-brain radiotherapy, SRS stereotactic radiosurgery, HR hazard ratio. Created using SAS software (version 9.4; SAS Institute Inc., Cray, NC, USA).
See this image and copyright information in PMC

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