Brain Metastases: Estimation of survival time after holocephalic radiotherapy in brain metastases

Abstract

Introduction: Brain metastases are an important cause of mortality and the most common intracranial tumors in adults, observed in approximately 20% and 40% of patients diagnosed with cancer. The prognostic factors that allow estimating life expectancy are the tools that should be used to propose the fractionation and duration of the radiant energy treatment.

Methods:  The present retrospective study was carried out at the Solón Espinosa Ayala Hospital, SOLCA-Quito. The patients who received whole brain radiotherapy in the study period from January 2003 to December 2018, were registered. For survival analysis, use the Kaplan Meier curves and the significance of differences with the long-range test with a 5% type I or alpha error. In addition, a bivariate analysis was performed with the Cox logistic regression model between the median survival and the variables: Karnofsky index (IK), age, number of brain metastases, extracranial metastases, primary tumor and the “Graded Prognostic Assessment” (GPA).

Results: 309 patients were registered and the median overall survival of patients with brain metastases treated with whole brain radiotherapy was 5 months. All factors affect survival (p ? 0.05); those who achieved the best results in terms of survival were: Karnofsky Performance Status (KPS) ? 90, age group between 51-60 years, patients with 1 brain metastasis, absence of extracranial metastases and brain metastases originated in breasts with Graded Prognostic Assessment (GPA) score between 3.5-4.

Conclusions: Age, KPS, number of brain metastases, presence of extracranial metastases, primary tumor and GPA are factors that allow estimating survival time in patients with brain metastases