Extra-cerebral metastasis - An independent predictor of survival in older patients with brain metastases receiving a local therapy plus whole-brain radiotherapy (WBRT)

Background/Aim: Although omitting whole-brain radiotherapy (WBRT) during the treatment of few brain metastases more popular, many patients receive local therapies plus WBRT. WBRT may be less reasonable for patients with poor overall survival (OS), particularly if they are older. This study aimed to identify predictors of OS in these patients. Patients and Methods: One-hundred-and-two older patients receiving a local therapy (surgery, radiosurgery, simultaneous integrated boost) and WBRT for 1-3 brain metastases were evaluated. Type of local therapy, WBRT-regimen, age, gender, performance status, primary tumour type, number of brain metastases, extra-cerebral metastasis, and interval from tumour diagnosis to treatment of brain metastases were analysed for OS. Results: Absence of extra-cerebral metastasis was significantly associated with increased OS on univariate analysis (p=0.001) and Cox regression analysis (risk ratio=2.13, p=0.002). Conclusion: Extra-cerebral metastasis is an independent predictor of OS and can be helpful when assigning a treatment to older patients with few brain metastases.