Authors : A.Sh. Yousefi Kashi, B. Mofid, H.R. Mirzaei and P. Azadeh
Abstract: Multiple brain metastases are a common health problem, frequently found in patients with cancer. The prognosis, even after treatment with Whole-Brain Radiation Therapy (WBRT) is poor with an average expected survival time of >6 months. To evaluate the prognostic factors associated with overall survival in patients with brain metastasis treated with Whole Brain Radio Therapy (WBRT) and estimate the potential improvement in survival for patients with brain metastases, stratified by Karnofsky Performance Status (KPS), gender, age, number of lesions, primary tumor site, surgery, chemotherapy and radiation doses and fractionation. From January 2007 to May 2010, 54 medical records of patients with diagnosis of brain metastasis, who received WBRT in the shohadaye tajrish in Tehran Iran were analyzed. The most common primary tumor type was breast (22.2%) followed by lung (21.9%), unknown primary (16.6%) and solitary brain metastasis was present in 29.6% of patients. The surgery followed by WBRT was used in 11.1% of patients and 88.9% of others patients were submitted at WBRT alone. About 36 patients (66.7%) received the fractionation schedule of 30 Gy in 10 fractions. The prognostic factors evaluated for overall survival were Karnofsky Performance Status (KPS), gender, age, number of lesions, primary tumor site, surgery, chemotherapy and radiation doses and fractionation. The OS in 1 and 2 years was 15, 3, 5 and 4%, respectively and the median survival time was 3.5 months. In the analysis, the significant prognostic factors associated with better survival were: KPS>70 (p<0.001), neurosurgery (p<0.001), primary tumor site breast (p<0.001) and solitary brain metastasis (p = 0. 01). In this series, the patients with higher perform status or primary tumor site breast or treated with surgery followed by whole brain radiotherapy had better survival. This data suggest that patients with cancer and a single metastasis to the brain may be treated effectively with surgical resection plus radiotherapy. The different gender, age, radiotherapy doses and fractionation schedules did not altered survival.
A.Sh. Yousefi Kashi, B. Mofid, H.R. Mirzaei and P. Azadeh, 2010. Overall Survival and Related Prognostic Factors in Metastatic Brain Tumors Treated with Whole Brain Radiation Therapy. Research Journal of Medical Sciences, 4: 213-216.