• Guang Xu, Xu Yang, Lin Zhang, and Meng Xu.
• Department of Oncology, the First Affiliated Hospital of Jinan University, Guangzhou City, Guangdong Province, P.R. China; Department of Radiotherapy, the Third Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, P.R. China.
• World Neurosurg. 2022 Aug 1; 164: e671-e680.

BackgroundOwing to the complexities of brain metastases (BMs), accurate and reliable prognostic and predictive factors remain critical roadblocks in patients with lung adenocarcinoma (LUAD) BMs who undergo stereotactic radiosurgery (SRS).MethodsIn total, 132 patients with LUAD BMs who underwent SRS were retrospectively analyzed; Cox proportional hazards analysis of imaging and clinical characteristics was used to identify independent predictors related to overall survival (OS) and progression-free survival (PFS).ResultsOur data indicated that initial brain metastasis velocity (iBMV), Karnofsky performance score (KPS), and Rvol (the sum of peritumoral edema volume/cumulative intracranial tumor volume) could potentially be independent prognostic factors for OS. iBMV ≥2 (P = 0.000), KPS <80 (P = 0.042), and Rvol ≥5.7 (P = 0.017) were strongly associated with unsatisfactory OS. The KPS and BM contrast enhancement were also identified as independent prognostic factors for PFS. A higher KPS (P = 0.004) and homogeneous BM contrast enhancement (P = 0.026) were strongly associated with longer PFS.ConclusionsCollectively, iBMV and Rvol are highly related to OS and could be used as potential prognostic indices in patients with LUAD BMs who underwent SRS. Furthermore, we also revealed that the KPS and BM contrast enhancement could be potential indices of PFS in LUAD BMs.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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