10031- MET-5 CHANGES IN PROGNOSTIC FACTORS IN PATIENTS WITH BRAIN METASTASES FROM LUNG CANCER

Abstract INTRODUCTION In recent years, lung cancer treatment has undergone a turning point. A retrospective analysis was conducted to examine the changes in prognostic factors over time in cases of brain metastasis. METHODS AND SUBJECTS The study included 186 patients with metastatic brain tumors from lung cancer treated at the Third Hospital of the Jikei University School of Medicine from 2014 to 2023. The study was divided into two 5-year periods, and a statistical analysis of background factors and factors related to survival time was performed retrospectively. Factors were extracted from pretreatment factors such as age, number of metastases, and metastasis to other organs, and treatment factors such as surgical treatment and chemotherapy. RESULTS The average survival time was significantly extended from 4.7 months in the first group(F) to 10.9 months in the second group(S). In S, the use of immune checkpoint inhibitors (ICI), cases of neuronal death, and cases of stereotactic radiation therapy increased, and whole-brain irradiation decreased. Factors related to prolonged survival in F were surgery, high Karnofsky Performance Status (KPS), stereotactic radiation therapy, and molecular targeted drugs (MTD), while in S, high KPS, stereotactic radiation therapy, use of MTD, and use of ICI. When limited to cases where ICI was used, prolonged prognosis was observed in adenocarcinomas not suitable for molecular targeted drugs, and squamous cell carcinoma and small cell carcinomas in all cases in which they were used. DISCUSSION AND CONCLUSION In the treatment of lung cancer brain metastases, opportunities for stereotactic radiation therapy and ICI have increased, and it has been shown that these drugs prolong prognosis. In particular, the number of treatment targets for ICI is likely to expand in the future, and their therapeutic effect on brain metastases alone has also been reported.