Prognosis of Brain Metastases (BM) Patient Received Whole Brain Radiation Therapy (WBRT) alone or in combination with Surgery at Dharmais National Cancer Center, Indonesia.

Purpose: WBRT and surgery are commonly used to improve the overall survival of BM patients. The study aims to evaluate the overall survival of patients treated with WBRT in combination with surgery or alone.

Methods: This study is a cohort retrospective of 148 BM patients from January 1st, 2021, to December 31st, 2022, and our follow-up on their overall survival up to July 1st, 2023. We collected data on treatments received either in combination with WBRT and surgery or alone. Information for age, sex, primary tumor types, and sites of metastases were collected. Median survival time, Kaplan-Meier curves, and its' log-rank statistics were presented, including the results of Cox regression analysis.

Results: The overall median survival of this sample was 4.3 months. Patients receiving WBRT exhibit higher survival rates than non-WBRT (median survival rates are 6.9 vs 1.5 months) but not surgery (4.0 vs 4.4 months). The primary tumors (breast, lung, and others) have no difference in the median survival rates. The survival rate using Kaplan-Meier showed a significant difference between patients with WBRT vs non-WBRT (log-rank p=0.0) but not for surgery. A Cox regression shows hazard ratio (HR) for patients receiving WBRT=0.34 [95% CI: 0.19-0.62; P<0.001] and when it is adjusted for surgery and other variables it exhibits only a small change.

Conclusion: BM patients who received WBRT had better survival than non-WBRT patients, which could reduce HR, but surgery was not statistically significant.  All BM patients should receive WBRT regardless of surgery.