Survival and prognostic factors in patients with brain metastasis: Single center experience.
OBJECTIVE
The purpose of this study was to evaluate the clinical status, prognostic factors and treatment modalities affecting survival in patients with brain metastasis. We aimed to evaluate the whole brain radiation therapy (WBRT) outcomes of patients with brain metastasis in our center.


METHODS
Clinical data of 315 patients referred to our center between 2004 and 2014 with metastatic brain cancers were collected and analysed for possible relationships between survival time, age, gender, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary tumor, number of brain lesions, surgery, radiation therapy scheme, extracranial metastatic status and primary disease control status.


RESULTS
The average patient age of onset was 58 years. The primary tumor site was lung (68%), breast (12%), melanoma (4%), colorectal (1.6%), sarcoma (1.3%) and unknown primary disease (4.4%). The rest of the patients had other primary sites. Eighty four (26.6%) patients had single brain metastasis, 71 (22.5%) had 2 or 3 lesions, and 159 (50.4%) patients had more than 3 lesions. Leptomeningeal involvement was seen in combination of paranchymal involvement in 11 (3.5%) patients. Fifty patients had undergone surgical resection. WBRT was delivered to all of the patients. Median overall survival was 6.7 months (95% CI, 5.80-7.74). Median overall survival of patients treated with combination of surgery and WBRT was significantly better compared with those treated with WBRT alone (13.5 vs 5.5 months, p=0.0001). One- and 2- year survival was 17 and 4.7%, respectively.


CONCLUSIONS
The present study concludes that brain metastasis is common in cancer patients. The best overall survival was obtained by surgery+NBRT in good-condition patients. Treatment should be tailored on an individual basis to all these patients.
Department of Radiation Oncology, Medical Faculty, Inonu University, Malatya, Turkey.
Kemal
K
Ekici
Oztun
O
Temelli
Mustafa
M
Dikilitas
Ibrahim
I
Halil Dursun
Nihal
N
Bozdag Kaplan
Ersoy
E
Kekilli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology*; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult