Abstract:

Objective To investigate overall survival and prognostic factors of patients with non-small cell lung cancer （NSCLC） and brain metastasis treated with concurrent thoracic chemoradiotherapy and brain irradiation. Methods Clinical data were collected on 52 NSCLC patients with only brain metastases. All patients received radiation at the primary thoracic tumor and brain metastatic lesions. The Kaplan Meier method was used to calculate overall survival，and survival curves were compared using the log-rank test. Multivariate Cox regression was used to identify independent prognostic factors for overall survival. Results The median follow-up period was 13.5 months（range，4-49）. Median survival time was 13.0 months（95% CI，11.2-14.8），and overall survival rates were 53.8% at 1 year，13.5% at 2 years，and 3.8% at 3 years. Among patients with GTV＜118 cm³，median survival was 14.0 months （95% CI：11.6-16.4） and overall survival rates were 66.7% at 1 year， 20.8%　at 2 years，and 8.3% at 3 years. Among patients with GTV≥118 cm³， median survival was 12.0 months（95%  CI：10.7-13.3） and the corresponding overall survival rates were 42.9%，0 and 0（χ²=5.648，P=0.017）. Median survival time was 13.0 months （95%  CI：10.8-15.2） for patients who were prescribed a thoracic radiation dose ≥66 Gy，whereas it was 14.0 months（95%  CI，10.8-17.2） for those prescribed a dose ＜66 Gy（χ²=0.064，P=0.80）. Multivariate analysis showed that primary tumor volume was an independent prognostic factor for overall survival. Conclusions Concurrent thoracic chemoradiotherapy and brain radiation are associated with favorable overall survival in patients with NSCLC with only brain metastasis. Primary tumor volume may predict overall survival in these patients.

Key words:  Lung neoplasm, Brain metastasis, Chemoradiotherapy, Radiotherapy, Efficacy, Prognosis