Harun DEMIR, Ibrahim BABALIOGLU, Muzaffer UGRAKLI, Elcin Ilke OKUR, Tugba ABACIGIL
Marmara Medical Journal - 2026;39(3):1-7
Objective: To evaluate clinical outcomes of whole-brain radiotherapy (WBRT) and identify prognostic factors associated with overall survival (OS) in non-small cell lung cancer (NSCLC) patients with brain metastases who were not candidates for stereotactic radiotherapy (SRT). Patients and Methods: In this retrospective study, 71 NSCLC patients with brain metastases who underwent WBRT were included. Clinical and treatment data were collected, and survival outcomes and prognostic factors were evaluated. Results: The median age was 65 years, and 78.9% of patients were male. Adenocarcinoma was the most common histological subtype (54.9%). A Karnofsky Performance Status (KPS) >=80 was observed in 74.6% of patients. Brain metastases were synchronous in 64.8% of cases, and 32.4% of patients had isolated intracranial disease. The median OS and intracranial progression-free survival (iPFS) following WBRT were both 3 months (95% CI: 1.0-5.0 and 1.7-4.3, respectively). In multivariate analysis, independent predictors of improved OS included KPS >=80 (HR=5.72), early radiologic response (HR=4.10), the use of immunotherapy or targeted agents as first-line systemic therapy (HR=5.26), and the presence of isolated brain metastasis (HR=4.53). Conclusion: These findings highlight key predictors of improved survival after WBRT and underscore its continued clinical relevance in carefully selected NSCLC patients ineligible for SRT.
