1. Overall survival after initial radiotherapy for brain metastases; a population based study of 2140 patients with non-small cell lung cancer.
- Author
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Karlsson AT, Hjermstad MJ, Omdahl T, Aass N, Skovlund E, Hellebust TP, Johansen S, Kaasa S, and Yri OE
- Subjects
- Cranial Irradiation, Humans, Male, Norway epidemiology, Prognosis, Radiosurgery, Retrospective Studies, Brain Neoplasms radiotherapy, Brain Neoplasms surgery, Carcinoma, Non-Small-Cell Lung radiotherapy, Lung Neoplasms radiotherapy
- Abstract
Background: Brain metastases (BM) occur in about 30% of all patients with non-small cell lung cancer (NSCLC). BM treatment guidelines recommend more frequent use of stereotactic radiotherapy (SRT). Overall, studies report no difference in overall survival (OS) comparing SRT to whole-brain radiotherapy (WBRT). We examined survival after radiotherapy for BM in a population-based sample from the South-Eastern Norway Regional Health Authority treated 2006-2018., Methods: We reviewed electronic medical records of 2140 NSCLC patients treated with SRT or WBRT for BM from 2006-2018. Overall survival (OS) was compared to predicted survival according to the prognostic systems DS-GPA and Lung-molGPA., Results: Use of SRT increased during the period, from 19% (2006-2014) to 45% (2015-2018). Median OS for all patients was 3.0 months, increasing from 2.0 (2006) to 4.0 (2018). Median OS after SRT was 7.0 months ( n = 435) and 3.0 months after WBRT ( n = 1705). Twenty-seven percent of SRT patients and 50% of WBRT patients died within 90 days after start of RT. Age ≥70, male sex, KPS ≤70, non-adenocarcinoma histology, ECM present, multiple BM, and WBRT were associated with shorter survival ( p < .001). Actual mOS corresponded best with predicted mOS by DS-GPA and Lung-molGPA for the SRT group., Conclusion: Overall survival after radiotherapy (RT) for BM improved during the study period, but only for patients treated with SRT. Survival after WBRT remains poor; its use should be questioned. DS-GPA and Lung-molGPA seem most useful in predicting prognosis considered for SRT.
- Published
- 2021
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