WCLC 2025 - Posters & ePosters-EP.09.05 Efficacy and Prognostic Factors of Radiotherapy in Brain Metastases From Non-Small Cell Lung Cancer Patients:A Retrospective Study

EP.09.05 Efficacy and Prognostic Factors of Radiotherapy in Brain Metastases From Non-Small Cell Lung Cancer Patients:A Retrospective Study

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This retrospective study evaluated the efficacy and prognostic factors of radiotherapy in treating brain metastases (BM) from non-small cell lung cancer (NSCLC) patients. NSCLC patients with BM have a poor prognosis, with median overall survival (OS) around 6 months and low survival rates at 1, 2, and 3 years. The study highlights that stereotactic body radiation therapy (SBRT) leads to better intracranial outcomes compared to whole brain radiotherapy (WBRT), improving median OS (10.4 vs. 6.5 months) and intracranial progression-free survival (iPFS) (7.1 vs. 5.9 months), while WBRT may worsen neurocognitive function.<br /><br />The research addressed whether existing prognostic tools like the Graded Prognostic Assessment (GPA), updated considering immunotherapy advances, require further revisions to incorporate radiotherapy factors such as biological effective dose (BED). Clinical factors significantly affecting radiotherapy outcomes were analyzed using Cox regression models, identifying several independent predictors of worse intracranial control and reduced iPFS. These include Karnofsky Performance Status (KPS) ≤ 70 (KPS 2), brain tumor size ≥ 3 cm, presence of spinal cord metastases, BED ≤ 40 Gy, and increased number of brain metastases (2 or more).<br /><br />Kaplan-Meier survival analysis confirmed that variables such as KPS score, tumor size, age, GPA score, liver and spinal metastases status, radiotherapy dosing, and brain tumor number influence survival outcomes. The study concludes that assessing these parameters pre-treatment is critical for tailoring radiotherapy plans and improving prognosis prediction. Focused monitoring of patients with poor performance status, larger and multiple brain lesions, and distant metastases can facilitate timely treatment adjustments and potentially better intracranial control.<br /><br />Overall, this study reinforces the importance of personalized radiotherapy strategies in NSCLC patients with brain metastases and suggests integrating radiotherapy dose metrics into prognostic assessments.

Asset Subtitle

Haiyu Zhou

Meta Tag

Speaker Haiyu Zhou

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

non-small cell lung cancer

brain metastases

radiotherapy

stereotactic body radiation therapy

whole brain radiotherapy

prognostic factors

overall survival

intracranial progression-free survival

Karnofsky Performance Status

biological effective dose