Presentation (CTI)

OBJECTIVES: The study explored the association between therapy (chemotherapy and radiotherapy) and overall survival in NSCLC patients with brain metastases identified the impact of demographic and clinical factors on survival outcomes.
METHODS: A retrospective cohort design using the SEER database was used to identify the survival outcomes among NSCLC patients diagnosed with brain metastases from 2016 to 2020. Patients treated with chemotherapy or radiotherapy were included. Those with incomplete data or alternative treatments were excluded. Descriptive statistics characterized the study population, and Kaplan-Meier analysis compared survival probabilities. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and adjust for confounders.
RESULTS: Among 4,548 patients, 75% received chemotherapy and 25% underwent radiotherapy. Kaplan-Meier analysis showed a significant higher survival rate in the chemotherapy group (29.2%) compared to radiotherapy (15.8%). A Cox model demonstrated the hazard ratio that radiotherapy patients had a 1.86-fold higher risk of mortality (HR=1.86, 95% CI:1.72-2.01). Male sex, non-adenocarcinoma subtypes and older age (50-59 years) were associated with worse outcomes. Asian or Pacific Islander patients exhibited better survival rates compared to other racial groups.
CONCLUSIONS: Chemotherapy provided superior survival benefits over radiotherapy in NSCLC patients with brain metastases. These findings underscore the need for optimizing therapeutic strategies and addressing disparities to improve outcomes in the population with brain metastases considering high risk. Future studies should explore integrating systematic and localized treatments such as immunotherapy to enhance survival outcomes.