Prognostic factors affecting the survival of patients with brain metastasis treated by whole brain radiotherapy: A regional cancer center experience from North West India

Background: Brain metastases are unfortunate consequences frequently found in patients with advanced cancer. The prognosis is poor with an average expected survival time of <6 months by all possible efforts (including radiotherapy). This retrospective study aims to determine survival and prognostic factors in patients with brain metastases who underwent whole brain radiotherapy (WBRT). Materials and Methods: From January 2005 to August 2010, a total of 186 patients with brain metastasis was analyzed with the help of available medical records. Of these, 140 patients who received WBRT ΁ chemotherapy were included in this study. The prognostic factors evaluated for overall survival were age, gender, Eastern Cooperative Oncology Group performance status, number of lesions, primary tumor site, extracranial metastases, chemotherapy, and radiotherapy. Results: The median overall survival was 4 months (95% confidence interval: 3.56-4.43), while 1- and 2-year survival rates were 8.57% and 3.57%, respectively. The most common primary tumor sites were the lung (n = 82; 44.08%) followed by the breast (n = 46; 24.73%), kidney (n = 11; 5.91%), and unknown primary (n = 11; 5.91%). The median overall survival was maximum (4 months) in patients with breast cancer. The 1-year overall survival rate was 8.57% (n = 12) for the whole group and 18.2% (6/33) in breast cancer patients (P = 0.058). In this study, the patients with higher performance status (P = 0.199), solitary brain metastasis (P < 0.0001), female (P = 0.201), and primary tumor under control (P = 0.223) had better survival. Conclusion: This study suggests that overall prognosis of patients with brain metastasis remains to be poor, 1-year survival being <10%. Patients with solitary metastasis and carcinoma breast have comparatively better prognosis.