Up to 40% of non-smallcell lung cancer (NSCLC) patients develop brain metastases (BMs). The potential benefits of radiotherapy (RT) in patients with poor performance status (PS) are questionable, with considerable risk for futile treatment. We analyzed overall survival after initial radiotherapy in NSCLC patients with BMs, focusing on the relationship between PS and survival after RT. This study reports a prospective observational study including consecutive 294 NSCLC patients with first-time BMs. Overall survival (OS) was calculated from the start of RT to death or last follow-up (1 June 2023). Overall, in the 294 included patients (median age 69 years), the median OS was 4.6 months; 2.5 months after WBRT (n= 141), and 7.5 months after SRT (n= 153). After WBRT, mOS was equally poor for patients with ECOG 2 (1.9 months) and ECOG 3–4 (1.2 months). After SRT, mOS for patients with ECOG 2 was 4.1 months; for ECOG 3 patients, mOS was 4 1.6 months. For NSCLC patients with ECOG 2 diagnosed with BMs who are not candidates for surgery or SRT, WBRT should be questioned due to short survival.
高达40%的非小细胞肺癌（NSCLC）患者会发生脑转移（BMs）。对于体能状态（PS）较差的患者，放疗（RT）的潜在获益存在疑问，且存在相当大的无效治疗风险。我们分析了伴有脑转移的非小细胞肺癌患者接受初始放疗后的总生存期，重点关注体能状态与放疗后生存之间的关系。本研究报道了一项前瞻性观察性研究，连续纳入294例首次发生脑转移的非小细胞肺癌患者。总生存期（OS）的计算从放疗开始至死亡或末次随访（2023年6月1日）。总体而言，在纳入的294例患者（中位年龄69岁）中，中位总生存期为4.6个月；其中全脑放疗（WBRT）组（n=141）为2.5个月，立体定向放疗（SRT）组（n=153）为7.5个月。在全脑放疗后，ECOG 2分患者的中位总生存期（1.9个月）与ECOG 3–4分患者（1.2个月）同样较差。在立体定向放疗后，ECOG 2分患者的中位总生存期为4.1个月；ECOG 3分患者为1.6个月。对于诊断为脑转移且不适合手术或立体定向放疗的ECOG 2分非小细胞肺癌患者，鉴于其生存期较短，全脑放疗的应用价值值得商榷。
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