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

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

JOURNAL=Frontiers in Oncology

VOLUME=9

YEAR=2019

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2019.01352

DOI=10.3389/fonc.2019.01352

ISSN=2234-943X

ABSTRACT=<p><bold>Purpose:</bold> 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.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> 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 (<italic>p</italic> = 0.717). Statistically significant factors of better OS after univariable analysis were no extracranial metastases (<italic>p</italic> = 0.016), BED<sub>10</sub>-SRT≥50Gy (<italic>p</italic> = 0.049), oligometastases (1–3 brain metastases) (<italic>p</italic> &lt; 0.001), GPA score≥2.5 (<italic>p</italic> = 0.003), RPA class I (<italic>p</italic> = 0.026), NSCLC tumor type (<italic>p</italic> = 0.006), targeted therapy (<italic>p</italic> &lt; 0.001) and controlled extracranial disease (<italic>p</italic> = 0.011). Multivariate analysis indicated that higher BED<sub>10</sub>-SRT (≥50Gy, HR = 0.504, <italic>p</italic> = 0.027), controlled extracranial disease (HR = 0.658, <italic>p</italic> = 0.039) and targeted therapy (HR = 0.157, &lt;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, <italic>p</italic> = 0.012) and targeted therapy (HR = 0.168, &lt; 0.001) were independent favorable predictors for OS.</p><p><bold>Conclusion:</bold> For patients with brain metastases, stable extracranial disease, higher BED<sub>10</sub>-SRT (≥50Gy) and targeted therapy may predict a favorable prognosis.</p>