Clinical and Demographic Outcomes of Brain Metastases Receiving Whole Brain Radiation: A Retrospective Study from a Tertiary Care Institute in Eastern India

Background: Brain Metastasis (BM) is associated with poor prognosis. It affects the Quality of Life (QOL) and causes significant morbidity. BMs are the most common intracranial neoplasm, with a total number that outnumber primary neoplasms by a ratio of 10:1. In the present study, we aim to analyze the clinicodemographic profile and treatment outcomes of brain metastasis. Also, try to identify factors associated with survival in patients with brain metastasis. Methods: A retrospective, single-institutional study of 151 patients with brain metastases was conducted from January 2018 to May 2019. Medical records were reviewed to collect demographic and clinical information. The aim was to analyze the demographic and clinical profiles of patients with brain metastasis. Additionally, it analyzes patient factors, tumor characteristics and treatment plans that may impact overall survival in patients with brain metastases. Results: The median age for diagnosis of brain metastasis was 50 years. 82 patients were male. The common primary metastasizing to the brain was lung carcinoma (61%), followed by breast carcinoma (16%). 58% had adenocarcinoma histology and 14% of patients had infiltrating ductal carcinoma. (54%) showed multiple metastases, which is more common than a single metastasis (39%). 7% of patients showed two sites of metastases. 60% of patients have Supratentorial lesions. 29% of patients showed both supra and infratentorial lesions. Among them, the frontal lobe was the most commonly involved site. Out of 151 patients, 90 patients showed frontal lobe metastasis. Parietal and cerebellar metastasis is the next common site for metastasis 60% of patients are diagnosed upfront for brain metastasis. 3% of patients developed brain metastasis after five years of primary diagnosis. The most commonly used dose prescription for Whole Brain Radiation (WBRT) is 30Gy/10 fractions or 20Gy/5 fractions. 54% patients treated with 30Gy/10fx dose prescription. Median survival for patients with brain metastasis was eight months (ranging from 1 month to 32 months). Younger age (40-50 years), breast primary with a single metastasis and developed brain metastasis after 1-2 years of primary diagnosis were associated with better survival. Conclusion: The study highlights that in patients with brain metastasis, the overall prognosis remains poor; however, younger patients (40-50 years) and those with a single brain lesion demonstrate relatively better survival outcomes. Other factors, such as gender, WBRT dose and site of lesion, did not significantly affect survival.