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Abstract
Patients with brain metastases (BM) can benefit from radiotherapy (RT), although the long-term benefits of RT remain unclear. We searched a Korean national health insurance claims database and identified 135,740 patients with newly diagnosed BM during 2002-2017. Propensity score matching (PSM) was used to evaluate survival according to RT modality, which included whole-brain radiotherapy (WBRT) and/or stereotactic radiosurgery (SRS). The 84,986 eligible patients were followed for a median interval of 6.6 months, and 37,046 patients underwent RT (43.6%). After the PSM, patients who underwent RT had significantly better overall survival after 1 year (42.4% vs. 35.3%, P < 0.001), although there was no significant difference at 2.6 years, and patients who did not undergo RT had better survival after 5 years. Among patients with BM from lung cancer, RT was also associated with a survival difference after 1 year (57.3% vs. 32.8%, P < 0.001) and a median survival increase of 3.7 months. The 1-year overall survival rate was significantly better for SRS than for WBRT (46.4% vs. 38.8%, P < 0.001). Among Korean patients with BM, especially patients with primary lung cancer, RT improved the short-term survival rate, and SRS appears to be more useful than WBRT in this setting.

Affiliations

Kawngwoo Park #  1 , Gi Hwan Bae #  2   3 , Woo Kyung Kim  1 , Chan-Jong Yoo  1 , Cheol Wan Park  4 , Soo-Ki Kim  5 , Jihye Cha  6 , Jin Wook Kim  7 , Jaehun Jung  8   9
1 Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea.
2 Department of Preventive Medicine, Gachon University College of Medicine, Incheon, 21565, Republic of Korea.
3 Gil Artificial Intelligence and Bigdata Convergence Center, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea.
4 Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea.
5 Department of Microbiology, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea.
6 Department of Radiation Oncology, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea.
7 Department of Neurosurgery, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
8 Department of Preventive Medicine, Gachon University College of Medicine, Incheon, 21565, Republic of Korea. eastside1st@gmail.com.
9 Gil Artificial Intelligence and Bigdata Convergence Center, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea. eastside1st@gmail.com.
# Contributed equally.