The Predictive Factors Of The Response Or Prognosis To Whole Brain Radiotherapy For Brain Metastases From Lung Cancer

Objective:Whole brain radiotherapy(WBRT)has been recognized as the standard treatment for patients with brain metastases.However,in recent years,with the wide application of stereotactic radiotherapy(SRS),the weight of WBRT in the treatment of brain metastasis has been reduced.With the prolongation of survival time,various late adverse reactions of WBRT have also been paid attention by oncologist.Therefore,we hope to find some clinical or imaging predictors related to WBRT short-term efficacy and prognosis,so that we can better screen out which patients are suitable for WBRT,so as to reduce the treatment-related adverse reactions,while not affecting the final outcome of patients.Methods:A tolal of 56 newly diagnosed brain metastases patients who diagnosed in the Second Hospital Affiliated of Soochow University from Jan.1,2015 to Dec.1,2018 were collected and analyzed.We collected the data of intracranial tumors(size,length,edema volume,etc.)using magnetic resonance imaging(MRI).RANO-BM score was used to determine the radiotherapy response(CR/PR/SD/PD)of brain metastases.SPSS 21.0 statistical software was used to analyze the correlation between intracranial lesions and clinical features,radiotherapy responsiveness and prognosis in newly diagnosed patients with brain metastases.Results:In the study of response to WBRT,16 patients achieved complete remission(CR),19 patients achieved partial remission(PR),13 patients had stable lesions(SD),and 8 patients had progressed intracranial lesions(PD).The objective remission rate of small-cell lung cancer patients was significantly higher than that of non-small-cell lung cancer patients(OR=4.912,95%CI=0.101-3.082,P<0.05).At the same time,we found that the maximum diameter of largest tumor was also related to the progress of intracranial lesions The larger the maximum diameter,the higher the possibility of disease progression(OR=0.943,95%CI=-0.11-0.007,P<0.05).In the survival study,the median survival time of 56 patients was 13.1 months,and 18 patients are still alive.We found that age(OR=1.047,95%CI=0.135-8.142,P<0.05)and KPS score(OR=0.957,95%CI=0.147-6.248,P<0.05)were independent prognostic factors.The older the patients and the lower the KPS score bring out the shorter their survival time.Conclusion:The pathological type of SCLC and the diameter of the largest tumor less than 25 mm are the independent predictors of the response to WBRT,which can be used as a reference index for patients with brain metastasis of lung cancer to choose whole brain radiotherapy or not.In the study about overall survival time,age and KPS score are important factors affecting the prognosis of patients,which is also consistent with previous studies.