(183) To Estimate the Frequency of Brain Metastases, Presentation of Metastases, Location, Treatment Pattern and paradigm changes in the Brain Metastases Management Among the Population of Southern Asia

Publication Number: 1176

Background: Brain metastases (BM) are the most common intracranial tumours in adults accounting for one-half of brain tumours. There is no hospital-based audits were conducted to address the treatment-related information including the primary site, presentation of metastases, the site of lesion in the brain, treatment pattern, and paradigm changes in the management among the population of Southern Asia.

Objectives: To estimate the frequency of BM, presentation of metastases, their location, treatment pattern, and paradigm changes in their management among the population of Southern Asia.

Methods: An ambispective study was conducted at the department of radiation oncology in a referral hospital in South Asia from 1st January 2007 to 31st December 2022. All consecutive BM patients of either gender and any age, treated with radiation therapy after radiological confirmation [magnetic resonance imaging (MRI) scan or computer tomography (CT) / positron emission tomography (PET) scan] and histologically proven BM were included in the audit analysis. The patient demographic data, clinical data including BM presentation, number of lesions, primary tumour, site of the metastatic lesion, and treatment patterns such as type of radiation therapy, surgery, and paradigm changes were recorded into data collection form. The descriptive data were presented in numbers and proportion. SPSS V26 was used for the statistical analysis.

Results: A total of 778 BM patients were included in this study. The average mean of patients was 51.3 (SD±13.8) years. Majority 238 (30.6%) patients were belonged the age group of 51-60 years. The primary site of BM was associated with lung cancer 356 (45.7%) followed by breast cancer 272 (34.9%). Of the 778 BM patients, 681 (87.5%) patients were presented with metachronous BM presentation followed by 87 (11.2%) patients with synchronous and 10 (1.3%) patients with precious. The most common site of BM was found in the frontal lobe 143/272 (52.3%) primarily arising from the breast. Stereotactic radiosurgery (SRS)/robotic radiosurgery using the CyberKnife treatment method increased from 0 to 40% over a period of 15 years while patients treated with conventional whole brain radiotherapy (WBRT) nearly the same per year. Currently, surgical procedures were comparatively high in 2022 [14 (13.7%)] than in 2007 [9 (10.7%)].

Conclusions: The study findings suggest that the primary site of BM was prominent in lung cancer and the majority were presented with metachronous and synchronous BM. Stereotactic radiosurgery using CyberKnife was a major treatment approach used for BM. These data helps to estimate the incidence of BM patients, type and location of tumors, radiation therapy modality, and requirement of machines among the Southern Asia population.