scholarly journals Assessment of Brain Metastasis at Diagnosis in Non–Small-Cell Lung Cancer: A Prospective Observational Study From North India

2021 ◽  
pp. 593-601
Author(s):  
Gundu Naresh ◽  
Prabhat Singh Malik ◽  
Sachin Khurana ◽  
Deepam Pushpam ◽  
Vinod Sharma ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Brain Imaging ◽  
Small Cell ◽  
Small Cell Lung ◽  
Prognostic Assessment ◽  
Graded Prognostic Assessment

PURPOSE The incidence of symptomatic brain metastasis at diagnosis in non–small-cell lung cancer (NSCLC) is 5%-10%, and up to 40% develop during the disease course. There is a paucity of data supporting the role of brain imaging at diagnosis in asymptomatic cases particularly from resource-constraint settings. Here, we present our experience of mandatory baseline brain imaging with contrast-enhanced computed tomography (CECT) scans of all patients with NSCLC. MATERIALS AND METHODS This was a prospective observation study of patients with NSCLC with mandatory baseline brain CECT and a CNS examination. All histology proven patients with NSCLC diagnosed between January 2018 and October 2019 were included irrespective of stage. RESULTS A total of 496 patients were enrolled. The median age was 57 years (range, 23-84) with majority being males (75%) and smokers (66%). The prevalence of epidermal growth factor receptor mutations and anaplastic lymphoma kinase fusions was 33.4% and 12%, respectively. Brain imaging leads to upstaging in 7% cases. The prevalence of brain metastases was 21% (n = 104), with half being asymptomatic (51%). Factors associated with higher proportion of brain metastasis were young age (≤ 40 years), adenocarcinoma histology, poor Eastern Cooperative Oncology Group performance status (3 and 4), and high neutrophil-lymphocyte ratio (NLR) (> 2.5). After a median follow-up of 10.8 months (95% CI, 7.33 to 12.73), the median overall survival was 7.46 versus 12.76 months (hazard ratio 0.67; 95% CI, 0.46 to 0.96; P = .03) in patients with and without brain metastases, respectively. On multivariate analyses, high NLR and molecular graded prognostic assessment affected the overall survival significantly. CONCLUSION In our study, 21% of patients had brain metastasis at diagnosis detected with a mandatory baseline brain imaging with CECT. NLR and molecular graded prognostic assessment are significant predictors of survival in patients with brain metastasis.

scholarly journals BMET-16. REVISED GRADED PROGNOSTIC ASSESSMENT FOR NON-SMALL CELL LUNG CANCER (NSCLC) BRAIN METASTASES (BM) IN THE ERA OF MOLECULAR PROFILING

2016 ◽  
Vol 18 (suppl_6) ◽  
pp. vi29-vi29
Author(s):  
Suresh Kumar Balasubramanian ◽  
Philipp Schmitt ◽  
Samuel Chao ◽  
Lilyana Angelov ◽  
Alireza Mohamaddi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Molecular Profiling ◽  
Small Cell ◽  
Small Cell Lung ◽  
Prognostic Assessment ◽  
Graded Prognostic Assessment

Revised graded prognostic assessment (GPA) index for small cell lung cancer (SCLC) patients (pts) with brain metastases (BM).

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 2090-2090
Author(s):  
Lingling Du ◽  
Samuel T. Chao ◽  
Vyshak Alva Venur ◽  
Eberechi Sandra Agwa ◽  
Paul Elson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Prognostic Assessment ◽  
Graded Prognostic Assessment

scholarly journals Comparative survival in patients with brain metastases from non-small-cell lung cancer treated before and after implementation of radiosurgery

2017 ◽  
Vol 24 (2) ◽  
pp. 146 ◽  
Author(s):  
J.N. Greenspoon ◽  
P.M. Ellis ◽  
G. Pond ◽  
S. Caetano ◽  
J. Broomfield ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

Introduction Survival after a diagnosis of brain metastasis in non-small-cell lung cancer (nsclc) is generally poor. We previously reported a median survival of approximately 4 months in a cohort of patients treated with whole-brain radiotherapy (wbrt). Since that time, we implemented a program of stereotactic radiosurgery (srs). In the present study, we examined survival and prognostic factors in a consecutive cohort of patients after the introduction of the srs program.Methods Data from a retrospective review of 167 nsclc patients with brain metastasis referred to a tertiary cancer centre during 2010–2012 were compared with data from a prior cohort of 91 patients treated during 2005–2007(“pre-srs cohort”).Results Median overall survival from the date of diagnosis of brain metastasis (4.3 months in the srs cohort vs. 3.9 months in the pre-srs cohort, p = 0.74) was not significantly different in the cohorts. The result was similar when the no-treatment group was excluded from the srs cohort. Within the srs cohort only, significant differences is overall survival were observed between treatment groups (srs, wbrt plus srs, wbrt, and no treatment), with improved survival being observed on univariate and multivariate analysis for patients receiving srs compared with patients receiving wbrt alone (p < 0.001).Conclusions No improvement in survival was observed for nsclc patients with brain metastases after the implementation of srs. Selected patients (younger age, female sex, good performance status, fewer brain metastases) treated with srs appeared to demonstrate improved survival. However, those observations might also reflect better patient selection for srs or a greater tendency to offer those patients systemic therapy in addition to srs.

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