AUTHOR=Qiu Jianjian , Ke Dongmei , Yu Yilin , Lin Hancui , Zheng Qunhao , Li Hui , Zheng Hongying , Liu Lingyun , Wang Zhiping , Wu Yahua , Liu Tianxiu , Li Jiancheng 

TITLE=A New Nomogram and Risk Stratification of Brain Metastasis by Clinical and Inflammatory Parameters in Stage III Small Cell Lung Cancer Without Prophylactic Cranial Irradiation

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.882744

DOI=10.3389/fonc.2022.882744

ISSN=2234-943X

ABSTRACT=Background: This study undertook to determine risk factors for developing brain metastasis (BM). To predict brain metastasis-free survival (BMFS) and overall survival (OS) combined several clinical parameters and inflammatory indexes.
Materials and Methods: A nomogram and risk stratification were developed based on multivariate analysis results. The prognostic index (PI) predicting the high risk of BM was calculated by multiplying the weighted factor (β coefficient) with each variable. 
Results: Thirty-two of one-hundred patients (32.0%) developed BM. Multivariate cox regression analysis revealed that concurrent chemotherapy (CCRT; hazard ratio (HR), 3.356; p = 0.020), monocyte-lymphocyte ratio (MLR; HR, 4.511; p = 0.002), neutrophil-lymphocyte ratio (NLR; HR, 4.023; p =0.033), and prognostic-nutrition index (PNI; HR, 2.902; p =0.018) were independent prognostic factors of BMFS. The nomogram has good accuracy in predicting BMFS, and the C-index was 0.73. The ROC curve showed that these risk factors have a good discriminant ability. Similarly, tumor location (HR, 1.675; p = 0.035) and MLR (HR, 2.076; p = 0.013) were independent prognostic factors of OS. In the subgroup analysis of OS, the good group has a better prognosis than other groups. Risk stratification by prognostic index, the high-risk group had worse BMFS than the low-risk group, which also has certain practical significance for clinical practice in OS. 
Conclusion: We developed a nomogram and corresponding risk stratification in stage III LS-SCLC patients developed BM. This model and risk stratification can help clinicians improve patient treatment management and better deliver personalized therapy.