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Risk of Brain Metastases in Patients With NSCLC

By: Cordi Craig
Posted: Thursday, May 31, 2018

According to a study published in the American Journal of Clinical Oncology, tumor size, histology, N status, sex, and age are significantly associated with the presence of brain metastases in patients with non–small cell lung cancer (NSCLC). Lead author Saiama N. Waqar, MBBS, of Washington University in St. Louis, and colleagues estimate that brain radiotherapy was indicated in more than 8% of patients with NSCLC within the first 4 months of diagnosis.

“As we expand our understanding of molecular determinants of brain metastasis, the present study will serve as a baseline platform of clinical predictors,” the authors noted.

Using the Surveillance, Epidemiology, and End Results (SEER) database, researchers used brain radiotherapy as a surrogate for the presence of brain metastases in patients diagnosed with NSCLC between 1988 and 1997. Patients were subdivided according to brain radiotherapy status at presentation as “none” or “radiation therapy indicated.” Brain radiotherapy was indicated at presentation in 10,963 patients (8.3%) in a pool of more than 131,000. Several tumor and patient factors were significantly associated with the presence of brain metastases, including female sex, younger age, histology, larger tumor size, higher tumor grade, and higher N stage. 

The authors posited that these results are likely an underestimation of brain metastases at presentation in patients with NSCLC, because magnetic resonance imaging was not commonly used during the selected study time frame.



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