Development and validation of a predictive nomogram for leptomeningeal metastasis risk in NSCLC brain metastases: role of tumor location, driver mutations, and stereotactic radiosurgery

Patients with adherent BMs and driver mutations appear to be associated with increased LM risk, while SRS may be associated with reducing this risk. Our novel nomogram incorporating these factors shows promising predictive performance in our cohort, potentially enabling effective risk stratification. These exploratory findings suggest high-risk patients with ventricle- or pia mater-adherent BMs and driver mutations might benefit from consideration of upfront SRS combined with targeted therapy, though prospective validation is needed.