Prognostic factors after whole-brain radiotherapy alone for brain metastases from malignant melanoma

Abstract

Background/Aim: Many patients with brain metastases from melanoma receive whole-brain radiotherapy (WBRT). WBRT-regimens must consider the patient's prognosis in order to deliver the best therapy. Patients and Methods: Seven factors were correlated to intracerebral control and survival after WBRT alone in 92 patients with melanoma: WBRT regimen, age at WBRT, gender, Karnofsky performance score (KPS), number of brain lesions, number of extracranial metastatic sites, and time from melanoma diagnosis to WBRT. Results: On univariate analyses, KPS ≥80 (p=0.075) showed a trend towards improved intracerebral control. Greater WBRT dose (p=0.029), age ≤60 years (p=0.002), KPS ≥80 (p<0.001) and no extracranial site (p=0.008) were positively correlated with survival. On multivariate analyses, KPS (hazard ratio=2.11, 95% confidence interval=1.28-3.47; p=0.003) and number of extracranial metastatic sites (hazard ratio=1.27, 95% confidence interval=1.02-1.56; p=0.030) maintained significance regarding survival. Conclusion: The study identified predictors of survival for patients with melanoma receiving WBRT for brain metastases that can contribute to selection of individualized therapies.