Prognostic nomogram for small-cell lung cancer patients with brain metastasis in China: A population-based real-world analysis

Small-cell lung cancer (SCLC) is one of the top malignancies that leads to brain metastasis (BM), and the prognosis for SCLC patients tends to be abysmal. However, there is a notable amount of heterogeneity among these patients, and a subset of them can be expected to survive much longer than average. Therefore, we aimed to develop a model to predict the prognosis of SCLC patients with BM. This retrospective study collected data from the medical records of 697 SCLC patients with brain malignancies treated at Shanxi Provincial Cancer Hospital from January 2008 to December 2018. Among them, 526 patients were used as the training cohort. Univariate and multivariate analyses were performed in this cohort to select independent risk factors that affect the prognosis of SCLC patients with BM, and a nomogram model was established. The remaining 171 patients were used as the validation cohort to verify the model. Our analysis showed that 7 pretreatment variables were related to the overall survival of SCLC patients with BM. These variables were incorporated into the model. Our predictive model performed well in validation and outperformed the lung diagnostic specific graded prognostic assessment. It may serve as a practical tool to guide individualized treatment decisions for SCLC patients with BM, helping to identify those suited for aggressive therapy versus supportive care. Future multicenter prospective studies are needed to validate its generalizability and explore optimized treatment strategies.