Cystic brain metastases had slower speed of tumor shrinkage but similar prognosis compared with solid tumors that underwent radiosurgery treatment

Abstract

Purpose

Traditionally, radiosurgery was considered less effective for patients with cystic brain metastases. However, comparisons of prognosis between cystic and solid brain metastases in cancer patients have been seldom reported. We aimed to compare the survival between cystic and solid brain metastases and assess risk factors for overall survival after brain metastases (BMOS) in patients who underwent radiosurgery treatment.

Patients and methods

The Kaplan–Meier method and multivariate Cox regression analysis were used to compare survival time and evaluate risk factors for BMOS.

Results

A total of 356 patients (including 498 brain metastases) were analyzed in our study, including 67 patients (67/356, 18.8%) with 75 cystic brain metastases. There is no statistical significance in BMOS between patients with cystic (17 months, range: 3–64 months) and solid (17.5 months, range: 1–65 months) brain metastases (P=0.148). However, the volume of cystic brain metastases decreased more slowly than solid brain metastases (P<0.05). The results indicated that high recursive partitioning analysis classification (P=0.006), large volume of brain metastases (P=0.006), and different primary lesion (especially gastrointestinal tract tumor) (P=0.001) were associated with poor prognosis in patients with brain metastases.

Conclusion

There is no difference in prognosis and local control between patients with cystic and solid brain metastases who underwent radiosurgery. However, the rate and speed of tumor shrinkage were lower in cystic brain metastases after radiotherapy. Patients with larger brain metastases had shorter survival time, regardless of cystic or solid brain metastases.

Keywords:

• cystic brain metastases
• radiosurgery treatment
• tumor shrinkage
• overall survival after brain metastases
• risk factors

Acknowledgments

This study was supported by research grants from National Natural Science Foundation of China (No. 81472797) and Tianjin Municipal Science and Technology Commission (No. 16JCQNJC10000).

Author contributions

HW and ZYY designed the study. XGW, YCS, and ZYY recruited patients. XYL, XCJ, HW, JSW, YD, ZQW, and FTL were involved in acquisition of data, follow-up, and statistical analysis. HW wrote the paper with ZYY and YHZ. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.