Whole brain radiotherapy-based combined modality treatment of brain metastases from non-small cell lung cancer: a retrospective analysis of prognostic factors.

BACKGROUND The prognostic factors for patients with brain metastases from non-small cell lung cancer treated with whole brain radiotherapy (WBRT)-based combined modality therapy were investigated. MATERIALS AND METHODS Out of 135 patients treated with WBRT, 47 (34.8%) received a radiation boost, 84 (62.2%) underwent systemic chemotherapy, and 39 (28.9%) were given epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). RESULTS The mean survival time was 9.3 months, and the 1-year and 2-year survival rates were 46.3 and 16.1%, respectively. In univariate analysis, improved survival was associated with age < 60 years, no extracranial metastasis, Karnofsky performance score ≥ 70, ≥ 3 cycles of chemotherapy after diagnosis of brain metastases, combined treatment with EGFR-TKIs, and no metastases in the cerebellum. In multivariate analysis, the above prognostic factors maintained significance with the exception of age. In an additional analysis of the 58 patients with 1-3 brain metastases, combination of WBRT with radiation boost was associated with better survival. CONCLUSION We confirm previously described prognostic factors. Moreover, we found the absence of cerebellar metastases to be an independent prognostic factor for favorable outcome.