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• W2150092021 abstract "To determine the predictors of long-term overall survival (OS) in patients with brain metastases (BM) from non-small cell lung cancer (NSCLC). We reviewed our records to identify patients with BM secondary to NSCLC with no prior history of malignancy and a confirmed date of NSCLC diagnosis or brain metastases between January 1, 2006 and December 31, 2009 who either received treatment or were followed at our institution with known treatment parameters. Date of brain metastasis (DOBM) was defined as the date BM was first seen on imaging. The primary endpoint was OS from DOBM. Age at initial diagnosis, adenocarcinoma (AC) vs non-adenocarcinoma, initial presentation with CNS-only metastatic disease (OM), time to brain metastases (TTBM) for non-OM patients, initial presentation with stage I-III disease (iNDM), resection of BM, and control of the primary were evaluated for their influence on OS. Univariate (UVA) and multivariate analyses (MVA) were performed using log-rank testing and Cox regression, respectively. The hazard ratios (HR) from the Cox regression were used to create a risk score for OS. All categorical variables and the RS were dichotomized at the median. We identified 98 patients with BM from NSCLC. BM were managed with whole brain radiation (WBRT) alone (n=51), surgery + WBRT (n=28), WBRT + stereotactic radiosurgery (SRS) (n=1), or other (n=18). With a median follow-up of 30.8 months for surviving patients, the median OS was 7.5 months, with 1-, 2-, and 3- year OS of 35%, 21%, and 14%, respectively. On UVA, improved OS was associated with: age less than 64.6 years at diagnosis (n=49, 50% of total), presentation with OM disease (n=21, 21%), TTBM > 4.4 months for non-OM patients, iNDM (n=45, 46%), brain resection (n=32, 33%), and control of the primary (n=33, 34%). On MVA, OM (HR 0.385, p=0.012), resection of > 1 BM (HR 0.404, p=0.0011), AC (HR 0.616, p=0.0451), and iNDM (HR 0.33, p<0.0001) were associated with superior OS. The MVA hazard ratios allowed a scoring system of 2 points for AC, 3 for resection, 3 for OM, and 4 if iNDM. For a summed score of 4 or less (effectively 0 or 1 factors), median OS was 3.1 months, with a 1-, 2-, and 3- year OS of 12%, 2%, and 2%, respectively. For scores above 4, median OS was 19 months with 1-, 2- and 3-year OS of 63%, 44%, and 29%. This retrospective series identifies a subset of patients with CNS metastases from NSCLC with longer OS. This scoring system may be useful in patient discussions and in determining which patients may benefit from more aggressive intracranial and systemic therapy." @default.
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• W2150092021 date "2012-11-01" @default.
• W2150092021 modified "2023-09-24" @default.
• W2150092021 title "Predictors of Survival After Brain Metastases From Non-small Cell Lung Cancer" @default.
• W2150092021 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1498" @default.
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