Analysis of prognostic factors in patients with brain metastases affecting survival
Abstract Introduction Brain metastases (BM) are associated with dismal prognosis as they cause significant morbidity and affect the quality of life of patients. Management of BM depends on the following factors: age, patient performance, size and the number of lesions, location of the tumor, comorbi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-11-01
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| Series: | Journal of the Egyptian National Cancer Institute |
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| Online Access: | https://doi.org/10.1186/s43046-022-00146-z |
| _version_ | 1811328715642109952 |
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| author | Sweety Gupta Sumit Singh Atokali Chophy Sharanya Nair Rachit Ahuja K. Kusum Deepa Joseph Rajnish Arora Amit Gupta Manoj Gupta |
| author_facet | Sweety Gupta Sumit Singh Atokali Chophy Sharanya Nair Rachit Ahuja K. Kusum Deepa Joseph Rajnish Arora Amit Gupta Manoj Gupta |
| author_sort | Sweety Gupta |
| collection | DOAJ |
| description | Abstract Introduction Brain metastases (BM) are associated with dismal prognosis as they cause significant morbidity and affect the quality of life of patients. Management of BM depends on the following factors: age, patient performance, size and the number of lesions, location of the tumor, comorbidities, primary tumor type, and extracranial disease burden. In the present study, the pattern of occurrence, clinical characteristics, treatment outcome of brain metastases, and factors, tumor characteristics, and treatment that may impact BM patients’ overall survival were analyzed. Methods Retrospective analysis of medical records of 116 patients with histologically proven primary site solid tumors with brain metastases was done in the present study. Clinicoradiological and pathological parameters were documented. The relationship between variables and outcome was assessed by univariate analysis using the Cox proportional regression model to reach a significance of p < 0.05, to determine independent predictors of overall survival. Results One hundred sixteen patients of BM from various solid malignancies were included. Age ranged from 18 to 81 years (median 53.5). One hundred four patients received WBRT with a dose range of 8–40Gy/1–15fr, 7 received SRS with a dose of 18–24Gy depending on the size of the metastatic lesion, and 2 received SRT 27–33Gy/3fr. At the time of final analysis, 47 patients with BM had expired, 60 were lost to follow-up, and 9 were alive. Median survival was 8.25 (0.5–32.5 months) months. Female gender (χ 2 = 8.423; p = 0.015), RPA I (χ 2 = 9.353; p = 0.05), and metachronous BM (χ 2 = 3.793; p = 0.03) were associated with better survival. Patients with age 41–50 years, adenocarcinoma lung histology, and supratentorial location survived more than 2 years but did not show any statistical significance. Conclusion Brain metastases portend a very dismal prognosis. Certain clinicoradiological and pathologic factors have been identified to affect survival. More prospective multicentric trials, with a larger sample size, need to be conducted to assess the benefit of radiation in patients with limited life expectancy and identify prognostic and predictive factors for survival. |
| first_indexed | 2024-04-13T15:30:56Z |
| format | Article |
| id | doaj.art-64265ffb892547dcacfdbe92f722069a |
| institution | Directory Open Access Journal |
| issn | 2589-0409 |
| language | English |
| last_indexed | 2024-04-13T15:30:56Z |
| publishDate | 2022-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian National Cancer Institute |
| spelling | doaj.art-64265ffb892547dcacfdbe92f722069a2022-12-22T02:41:23ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092022-11-013411710.1186/s43046-022-00146-zAnalysis of prognostic factors in patients with brain metastases affecting survivalSweety Gupta0Sumit Singh1Atokali Chophy2Sharanya Nair3Rachit Ahuja4K. Kusum5Deepa Joseph6Rajnish Arora7Amit Gupta8Manoj Gupta9Department of Radiation Oncology, AIIMS RishikeshDepartment of Radiation Oncology, AIIMS RishikeshDepartment of Radiation Oncology, AIIMS RishikeshDepartment of Radiation Oncology, AIIMS RishikeshDepartment of Radiation Oncology, AIIMS RishikeshCollege of Nursing, AIIMS RishikeshDepartment of Radiation Oncology, AIIMS RishikeshDepartment of Neurosurgery, AIIMS RishikeshDepartment of Surgery, AIIMS RishikeshDepartment of Radiation Oncology, AIIMS RishikeshAbstract Introduction Brain metastases (BM) are associated with dismal prognosis as they cause significant morbidity and affect the quality of life of patients. Management of BM depends on the following factors: age, patient performance, size and the number of lesions, location of the tumor, comorbidities, primary tumor type, and extracranial disease burden. In the present study, the pattern of occurrence, clinical characteristics, treatment outcome of brain metastases, and factors, tumor characteristics, and treatment that may impact BM patients’ overall survival were analyzed. Methods Retrospective analysis of medical records of 116 patients with histologically proven primary site solid tumors with brain metastases was done in the present study. Clinicoradiological and pathological parameters were documented. The relationship between variables and outcome was assessed by univariate analysis using the Cox proportional regression model to reach a significance of p < 0.05, to determine independent predictors of overall survival. Results One hundred sixteen patients of BM from various solid malignancies were included. Age ranged from 18 to 81 years (median 53.5). One hundred four patients received WBRT with a dose range of 8–40Gy/1–15fr, 7 received SRS with a dose of 18–24Gy depending on the size of the metastatic lesion, and 2 received SRT 27–33Gy/3fr. At the time of final analysis, 47 patients with BM had expired, 60 were lost to follow-up, and 9 were alive. Median survival was 8.25 (0.5–32.5 months) months. Female gender (χ 2 = 8.423; p = 0.015), RPA I (χ 2 = 9.353; p = 0.05), and metachronous BM (χ 2 = 3.793; p = 0.03) were associated with better survival. Patients with age 41–50 years, adenocarcinoma lung histology, and supratentorial location survived more than 2 years but did not show any statistical significance. Conclusion Brain metastases portend a very dismal prognosis. Certain clinicoradiological and pathologic factors have been identified to affect survival. More prospective multicentric trials, with a larger sample size, need to be conducted to assess the benefit of radiation in patients with limited life expectancy and identify prognostic and predictive factors for survival.https://doi.org/10.1186/s43046-022-00146-zMetastasesBrainWhole brain radiotherapySurvival |
| spellingShingle | Sweety Gupta Sumit Singh Atokali Chophy Sharanya Nair Rachit Ahuja K. Kusum Deepa Joseph Rajnish Arora Amit Gupta Manoj Gupta Analysis of prognostic factors in patients with brain metastases affecting survival Journal of the Egyptian National Cancer Institute Metastases Brain Whole brain radiotherapy Survival |
| title | Analysis of prognostic factors in patients with brain metastases affecting survival |
| title_full | Analysis of prognostic factors in patients with brain metastases affecting survival |
| title_fullStr | Analysis of prognostic factors in patients with brain metastases affecting survival |
| title_full_unstemmed | Analysis of prognostic factors in patients with brain metastases affecting survival |
| title_short | Analysis of prognostic factors in patients with brain metastases affecting survival |
| title_sort | analysis of prognostic factors in patients with brain metastases affecting survival |
| topic | Metastases Brain Whole brain radiotherapy Survival |
| url | https://doi.org/10.1186/s43046-022-00146-z |
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