The impact of whole brain radiation therapy on overall survival in patients with extensive stage small cell lung cancer with brain metastases
Ma Jintao, Jia Huijun, Meng Chunliu, Ren Kai, Yu Hao, Xu Liming, Liu Ningbo, Wang Ping, Zhao Lujun
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
Abstract：Objective To evaluate whether whole brain radiation therapy(WBRT) could benefit small cell lung cancer (SCLC) patients with brain metastases. Methods Clinical data of 245 patients who were diagnosed with extensive stage SCLC with brain metastases admitted to our hospital from 2010 to 2020 were retrospectively analyzed. Among them, 168 patients received WRBT (WBRT group, radiation dose: 30Gy in 10 fractions), and 77 patients did not receive WBRT (non‐WBRT group). All patients received 4‐6 cycles of chemotherapy, and the chemotherapy regimen included cisplatin (or carboplatin) plus etoposide. One hundred and fifteen patients received thoracic radiotherapy. The endpoint was overall survival after brain metastases(BM‐OS). Chi-square test was used to compare categorical data, and stabilized inverse probability of treatment weighting(sIPTW) was used to match the factors between WBRT and no‐WBRT groups. Survival analysis was estimated by Kaplan‐Meier method, and the log‐rank test was used to compare survival curves between two groups. Results The median BM‐OS for the whole group of patients was 9.1 months, and 10.6 months and 6.7 months in the WBRT and non‐WBRT groups, respectively(P=0.003). After balanced influencing factors with stabilized sIPTW, significant difference still existed in BM‐OS between two groups(P=0.02). In 118 patients with synchronous brain metastases, the median BM‐OS in two groups were 13.0 months and 9.6 months(P=0.007); and in 127 patients with metachronous brain metastases, the median BM‐OS were 8.0 months and 4.1 months(P=0.003). In 50 patients without extracranial metastases, the median BM‐OS were 13.3 months and 10.9 months(P=0.259)in two groups; while in 195 patients with extracranial metastases, the median BM‐OS were 9.5 months and 5.9 months(P=0.009)in two groups. Conclusions WBRT could prolong the OS in extensive stage SCLC patients with brain metastases.
Ma Jintao,Jia Huijun,Meng Chunliu et al. The impact of whole brain radiation therapy on overall survival in patients with extensive stage small cell lung cancer with brain metastases[J]. Chinese Journal of Radiation Oncology, 2022, 31(10): 891-896.
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