Prognostic Factors and Survival Outcomes in Lung Cancer Patients with Brain Metastasis: A Retrospective Study

Background: Brain metastases (BM) are a serious complication in non-small cell lung cancer (NSCLC), affecting up to ‎‎40% of patients and contributing to substantial morbidity and mortality. Although historically linked to ‎poor prognoses, advancements in systemic and local therapies such as immunotherapy and ‎stereotactic radiosurgery (SRS)—have improved survival rates. Objective: This study aimed to valuate prognostic factors and ‎survival outcomes in NSCLC patients with BM.‎ Methods:‎ This retrospective study examined 110 NSCLC patients with BM treated with whole-brain radiation therapy ‎‎(WBRT) diagnosed between 2018 to 2022. Eligible patients had pathologically confirmed NSCLC, imaging-‎verified BM, and documented clinical data. Survival outcomes were analyzed via the Kaplan-Meier method, ‎while Cox proportional hazards regression identified significant prognostic indicators influencing overall ‎survival (OS).‎ Results: The median patient age was 57.2 years, with adenocarcinoma as the predominant histology (61.8%). Most ‎patients (87.2%) had extracranial metastases (ECM) at BM diagnosis, and 70% received systemic therapy. ‎Median OS was 13 months, with improved survival (median OS: 18 months) observed in those receiving ‎localized treatment alongside WBRT. Prognostic factors included metastatic timing (P < 0.001), number of ‎brain metastases (P = 0.045), local treatment modality (P = 0.039) and post-BM systemic therapy (P = ‎‎0.001).‎ Conclusion: Prognostic factors influencing survival in NSCLC patients with BM included metastatic timing, lesion count, ‎treatment modality and systemic therapy. Patients receiving localized treatment with WBRT had better ‎survival. The high prevalence of ECM (87.2%) highlights the systemic nature of NSCLC, emphasizing the ‎need for comprehensive therapeutic approaches.‎