Clinical-radiological prognostic factors in patients with brain metastasis-A retrospective study from a tertiary care centre In Easten India

• Main Authors: Rashmi Singh, Anup Kumar, Praveer K S Munda, Rajanigandha Tudu, Payal Raina
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Journal of Radiation and Cancer Research
• Subjects: brain metastasis; clinical; outcome; prognostic factors; radiological
• Online Access: http://www.journalrcr.org/article.asp?issn=2588-9273;year=2021;volume=12;issue=2;spage=53;epage=58;aulast=Singh
• ISSN: 2588-9273; 2468-9203

Background: Brain metastasis (BM) is the most common (MC) intracranial tumor in adults. The outcome depends upon prognostic factors (PF) and optimal use of multimodality treatment. Objectives: We aimed to know clinicoradiological PF and their correlation in BM patients. Materials and Methods: Retrospectively, 19 BM patients treated with radiotherapy (RT) for the same between January 2018 and December 2019 were selected. Details of age, sex, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary diagnosis, histopathology report, imaging details for BM-number, size and location, extracranial metastasis (EM), and primary tumor control (PTC) status were collected from the physical records. Descriptive statistics for the categorical variables and Bi-variate Spearman correlation were used to analyze the correlation between BM size, number, type of primary (TOP) with RPA, KPS, age, gender, PTC, and EM individually using the SPSS software version 20. Results: 84.2% of patients were <65 years age and 57.8% were males. Lung cancer was the MC primary (73.7%). The PF in majority were KPS <70 (52.6%), RPA III (52.63%), multiple BM lesions (73.7%), uncontrolled primary (78.9%), and BM size >1.5 cm (84.2%). EM was observed in 31.6% patients. 94.73% and 68.4% of patients received whole-brain RT and systemic treatment, respectively. The maximum duration of FU was 12 months and 78.9% of patients were lost to FU post-RT. Significant correlation was observed between BM size and RPA class, KPS (R = 0.456; P = 0.049), and TOP correlated with gender (P = 0.028) and PTC (P = 0.000). However, no significant correlation between the age, RT dose, EM, number of lesions and RPA, PS (P = 0.339). Conclusions: The presence of multiple poor PF in majority of our patients and their poor follow-up indicate inertness toward health issues. Furthermore, larger BM lesions correlated with higher RPA suggesting poor outcome, so treatment modality to be judicially selected. The positive correlation between gender, PTC and primary cancer, and their prognostic role in BM should be validated in the larger studies.