Analysis of efficacy prognostic of non-small cell lung cancer with brain metastasis and peritumoral edema zone undergoing whole brain radiation combined with stereotactic radiotherapy

Abstract

Objective To study the efficacy and prognostic factors of twenty patients diagnosed with non-small cell lung cancer (NSCLC) and 1-5 brain metastases (BM) with obvious peritumoral edema, undergoing whole brain radiation therapy (WBRT) plus stereotactic radiotherapy for tumors of 1-3 cm in size. Methods Twenty patents with NSCLC and 1-5 BM lesions as well as peritumoral edemas, undergoing WBRT followed by stereotactic radiotherapy within 3 to 6 months were enrolled. The overall survival was estimated by Kaplan-Meier analysis. The potential prognostic factors related to survival were evaluated. Results For all patients, the median survival time from the start of WBRT was 15.6 months. Univariate analysis showed that control of primary lesions in chest, extracranial metastasis, KPS score, GPA grade, targeted therapy, brain metastasis diameter and peritumoral edema band diameter were the independent prognostic factors affecting the survival of patients. Multivariate analysis showed that the prognostic factors affecting the survival of patients were control of primary thoracic lesions, extracranial metastasis, GPA classification, targeted therapy, the maximum diameter of tumors and the peritumoral edema band diameter. The survival time for patients with brain metastases larger than 2 cm in tumor diameter and 3 cm in peritumoral edema zone was shorter (P<0.05). The median progression-free survival time was 9.28 months, and the 6-month, 1-year and 2-year survival rates were 90%, 65% and 15%, respectively. Conclusions Control of primary thoracic lesions, extracranial metastasis, GPA classification, targeted therapy, the maximum diameter of tumors and the peritumoral edema band diameter were the independent predictive factors of survival. For NSCLC patients with 1-5 brain metastases and peritumoral edemas, a stereotactic radiotherapy dosage boost post WBRT edema relief resulted in a definite effect and prolonged survival. Key words: Non-small cell lung cancer; Brain metastasis; Stereotactic radiotherapy; Peritumoral edema zone; Prognostic factors