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Purpose: To define the factors which may be related to brain metastasis (BM) in patients with locally advanced non-small cell lung cancer (LA-NSCLC) who developed brain metastases after definitive treatment. Patients and methods: A total of 208 patients with LA-NSCLC, without BM who received definitive radiotherapy (RT) or RT + chemotherapy (CT) between January 2005 and January 2016 were evaluated retrospectively. Platelet, neutrophil, lymphocyte counts, LDH, CRP, Hb levels, neutrophil-to-lymphocyte radio (NLR), platelet-to-lymphocyte radio (PLR), advanced lung cancer inflammation index (ALI) and FDG-PET/CT parameters (SUVmax of the primary tumor and mediastinal lymph nodes), and patient characteristics were evaluated for brain metastasis free survival (BMFS). Results: Median follow-up duration was 25 months (range: 3–130 months). Cut-off values for platelet, NLR, PLR, LDH, CRP, and Hb were 290 × 103/?L, 2.6, 198, 468 IU/L, 2.5 mg/dL, and 11.5 g/dl. We defined each parameter as low or high according to the cut-off values. 56 patients (26.9%) developed brain metastases during follow-up. In univariate analysis, high NLR (P = 0.001), PLR (P = 0.037), LDH (P = 0.028), CRP (P = 0.002) values, value ? 7.5 for lymph nodes (P = 0.005) and low ALI value (P = 0.002) were poor prognostic factors for BMFS. In multivariate analysis, high NLR (P = 0.022), PLR (P = 0.017), CRP (P = 0.006), stage ? IIIB disease (P < 0.001), multi-stational N2 disease (P = 0.036), adenocarcinoma histology (P < 0.001) and SUVmax value ? 7.5 (P = 0.035) were poor prognostic factors for BMFS. Conclusions: High NLR, PLR, LDH, CRP values, SUVmax values for lymph nodes, and low ALI which indicates high tumor burden were additional prognostic factors besides stage, histology, and lymph node status. © 2020 Société française de radiothérapie oncologique (SFRO) |
