Prognostic factors of metastatic tumor to the brain

Objective: To evaluate the prognostic factors of metastatic tumor to the brain and suggest a proposal for individualized treatment with estimation of prognosis. Methods: 371 patients with metastatic lesions to the brain were retrospectively analyzed. The chief prognostic factors evaluated were: gender, age, histological type, primary tumor site, Kamofsky performance status (KPS), value of Hb, primary tumor control, extracranial metastasis and treatment. Kaplan-Meier method was used to analyze the survival. Logrank test was used to evaluate the difference between the groups. Cox regressive model was used to analyze the prognostic factors. Recursive partitioning analysis (RPA) classification by the standard of RTOG was also compared by Logrank test. Results: The overall 1-, 2- and 3-year survival rates were 37.8%, 18.4% and 12.2% with a median survival time of 8.0 months. In multivariate analysis, KPS, primary disease control and treatment were independent prognostic factors. The median survival time of classes 1, 2 and 3 according to RPA classification was 22.0, 9.0 and 5.0 months, which were significantly different. Conclusions: The main prognostic factor's of metastatic tumor to the brain are KPS, primary disease control and the number of brain metastasis. The survival is prolonged by proper treatment. The recursive partitioning analysis classification is in accordance with the brain metastasis. (authors)