{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:59:11Z","timestamp":1789268351157,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81872324"],"award-info":[{"award-number":["81872324"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["A2020149"],"award-info":[{"award-number":["A2020149"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Medical Scientific Research Foundation of Guangdong Province of China","doi-asserted-by":"publisher","award":["81872324"],"award-info":[{"award-number":["81872324"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Medical Scientific Research Foundation of Guangdong Province of China","doi-asserted-by":"publisher","award":["A2020149"],"award-info":[{"award-number":["A2020149"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Radiotherapy and surgery are the standard local treatments for lung cancer brain metastases (BMs). However, limited studies focused on the effects of radiotherapy and surgery in lung cancer BMs with poor prognosis factors. Methods: We retrospectively analyzed 714 patients with lung cancer BMs. Analyses of overall survival (OS) and risk factors for OS were assessed by the log-rank test and Cox proportional hazard model. Results: Age \u2265 65 years, a Karnofsky Performance Scale (KPS) score \u2264 70, anaplastic large-cell lymphoma kinase (ALK)\/epidermal growth factor receptor (EGFR) wild type, and extracranial metastases were related to poor prognosis. Patients were stratified according to these poor prognosis factors. In patients with the ALK\/EGFR wild type, whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), and surgery improved the OS of patients. WBRT and SRS were the independent protective factors for OS. In patients with extracranial metastases, patients who received WBRT plus SRS or WBRT alone had longer OS than those who did not receive radiotherapy. WBRT plus SRS and WBRT were the independent protective factors for OS. Conclusions: Radiotherapy and surgery are associated with improved survival for lung cancer BMs with the ALK\/EGFR wild type. Radiotherapy is associated with improved survival in lung cancer BMs with extracranial metastases.<\/jats:p>","DOI":"10.3390\/curroncol30020172","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T06:09:21Z","timestamp":1676268561000},"page":"2227-2236","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Survival Benefits of Radiotherapy and Surgery in Lung Cancer Brain Metastases with Poor Prognosis Factors"],"prefix":"10.3390","volume":"30","author":[{"given":"Lun","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenning","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"},{"name":"Department of Neurosurgery, Dongguan People\u2019s Hospital (Affiliated Dongguan Hospital, South Medical University), Dongguan 523058, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenqiang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongrong","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengwei","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2853-6347","authenticated-orcid":false,"given":"Sheng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Run","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Ji\u2019nan University, Guangzhou 518053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxiong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggao","family":"Mou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1038\/s41572-018-0055-y","article-title":"Brain metastases","volume":"5","author":"Achrol","year":"2019","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/PPO.0000000000000146","article-title":"Lung Cancer Brain Metastases","volume":"21","author":"Goldberg","year":"2015","journal-title":"Cancer J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1200\/JCO.2010.30.1655","article-title":"Adjuvant Whole-Brain Radiotherapy Versus Observation After Radiosurgery or Surgical Resection of One to Three Cerebral Metastases: Results of the EORTC 22952\u201326001 Study","volume":"29","author":"Kocher","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/S1470-2045(17)30414-X","article-title":"Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: A single-centre, randomised, controlled, phase 3 trial","volume":"18","author":"Mahajan","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJM199002223220802","article-title":"A Randomized Trial of Surgery in the Treatment of Single Metastases to the Brain","volume":"322","author":"Patchell","year":"1990","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1093\/neuonc\/now197","article-title":"Systemic therapy of brain metastases: Non\u2013small cell lung cancer, breast cancer, and melanoma","volume":"19","author":"Chamberlain","year":"2017","journal-title":"Neuro-Oncology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/neuros\/nyx376","article-title":"Long-Term Survivorship Following Stereotactic Radiosurgery Alone for Brain Metastases: Risk of Intracranial Failure and Implications for Surveillance and Counseling","volume":"83","author":"Gogineni","year":"2017","journal-title":"Neurosurgery"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1001\/jamaoncol.2016.3834","article-title":"Estimating Survival in Patients with Lung Cancer and Brain Metastases An Update of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA)","volume":"3","author":"Sperduto","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.ijrobp.2009.08.025","article-title":"Diagnosis-Specific Prognostic Factors, Indexes, and Treatment Outcomes for Patients with Newly Diagnosed Brain Metastases: A Multi-Institutional Analysis of 4259 Patients","volume":"77","author":"Sperduto","year":"2010","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.ijrobp.2014.10.024","article-title":"Phase 3 Trials of Stereotactic Radiosurgery with or without Whole-Brain Radiation Therapy for 1 to 4 Brain Metastases: Individual Patient Data Meta-Analysis","volume":"91","author":"Sahgal","year":"2015","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1016\/S0140-6736(16)30825-X","article-title":"Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): Results from a phase 3, non-inferiority, randomised trial","volume":"388","author":"Mulvenna","year":"2016","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.ijrobp.2017.02.031","article-title":"Use of Stereotactic Radiosurgery in Elderly and Very Elderly Patients with Brain Metastases to Limit Toxicity Associated with Whole Brain Radiation Therapy","volume":"98","author":"Chen","year":"2017","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s11060-019-03242-8","article-title":"Stereotactic radiosurgery in elderly patients with brain metastases: Comparison with non-elderly patients using database of a multi-institutional prospective observational study (JLGK0901-Elderly)","volume":"144","author":"Higuchi","year":"2019","journal-title":"J. Neuro-Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s11060-012-1016-z","article-title":"Stereotactic radiosurgery in elderly patients with brain metastases","volume":"111","author":"Minniti","year":"2013","journal-title":"J. Neuro-Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Yomo, S., and Hayashi, M. (2016). Is upfront stereotactic radiosurgery a rational treatment option for very elderly patients with brain metastases? A retrospective analysis of 106 consecutive patients age 80 years and older. BMC Cancer, 16.","DOI":"10.1186\/s12885-016-2983-9"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/0360-3016(94)90558-4","article-title":"The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age","volume":"29","author":"Noordijk","year":"1994","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.6004\/jnccn.2020.0052","article-title":"Central Nervous System Cancers, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology","volume":"18","author":"Nabors","year":"2020","journal-title":"J. Natl. Compr. Cancer Netw. JNCCN"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1001\/jama.295.21.2483","article-title":"Stereotactic Radiosurgery Plus Whole-Brain Radiation Therapy vs Stereotactic Radiosurgery Alone for Treatment of Brain Metastases: A randomized controlled trial","volume":"295","author":"Aoyama","year":"2006","journal-title":"JAMA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/jama.2016.9839","article-title":"Effect of Radiosurgery Alone vs Radiosurgery with Whole Brain Radiation Therapy on Cognitive Function in Patients with 1 to 3 Brain Metastases: A Randomized Clinical Trial","volume":"316","author":"Brown","year":"2016","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/S1470-2045(09)70263-3","article-title":"Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: A randomised controlled trial","volume":"10","author":"Chang","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_21","first-page":"CD003869","article-title":"Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases","volume":"1","author":"Tsao","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1200\/JCO.21.02314","article-title":"Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline","volume":"40","author":"Vogelbaum","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1093\/neuonc\/now241","article-title":"Diagnosis and treatment of brain metastases from solid tumors: Guidelines from the European Association of Neuro-Oncology (EANO)","volume":"19","author":"Soffietti","year":"2017","journal-title":"Neuro-Oncology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1001\/jama.280.17.1485","article-title":"Postoperative Radiotherapy in the Treatment of Single Metastases to the Brain: A randomized trial","volume":"280","author":"Patchell","year":"1998","journal-title":"JAMA"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/2\/172\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:32:58Z","timestamp":1760121178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/2\/172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,13]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["curroncol30020172"],"URL":"https:\/\/doi.org\/10.3390\/curroncol30020172","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,13]]}}}