OBJECTIVE

To study the predictors of long-term survival.

SUBJECTS AND METHODS

Since January 2014, the Department of Radiotherapy, P.A. Herzen Moscow Oncology Research Institute, has performed whole brain radiotherapy (WBRT) in 128 patients at the first stage after identifying a metastatic brain lesion. Subsequently, the boost was used in 47 (36.7%) patients; the last boost was done at 2.76 to 20.76 months after WBRT with a median of 6.86 months in 30 (23.4%) patients, the standard boost was given immediately after WBRT in 17 (13.3%). Breast cancer was diagnosed in 75 (58.6%) patients; non-small cell lung cancer was in 53 (41.4%) patients.

RESULTS

Multivariate analysis showed that a proportional hazards model was used to identify four independent favorable prognostic factors for long-term survival, such as belonging to a low-risk group according to the short-term survival prognostic scale (OR=2.762; p<0.0001), no meningeal carcinomatosis (OR=2.523; p<0.0001), boost use at various times after WBRT (OR=2.598; p<0.0001), and a more than 30-month interval between the appearance of brain metastases and the start of primary treatment (OR=0.396; p<0.0001).

Of certain importance is a patient’s good functional status (the Karnofsky Performance Scale Index of 80%) before WBRT (OR=1.748; p=0.022), a controlled primary focus (OR=1.789; p=0.021), continuation of drug therapy (including targeted therapy) after WBRT (OR=0.613; p=0.030).

CONCLUSION

The high statistical significance of the identified parameters will be able to detect patients with a predicted long life, which will lead to optimization of the timing of radiation and drug treatments, as well as radiotherapy for metastatic brain lesion.