Sequence of Radiation and Targeted Therapy in Brain Metastases

Study Overview
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Brief Summary
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The investigators conducted a single institutional, retrospective cohort study to demonstrate the appropriate treatment strategy of upfront intracranial radiotherapy or upfront targeted therapy in patients with brain metastases, including an assessment of its feasibility and toxicity.

Official Title
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The Optimal Sequence of Intracranial Radiotherapy Compared to Systematic Tyrosine Kinase Inhibitors for Gene-driven Brain Metastases in Targeted Treatment Era

Conditions
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The Optimal Sequence of Radiotherapy and Systematic Tyrosine Kinase Inhibitors in Treating Brain Metastases

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Had histologically proven primary cancer. Had newly diagnosed brain metastases in contrast-enhanced MRI. Brain metastases focus should be measurable. All the patients should safely receive radiotherapy and/or systematic tyrosine kinase inhibitors. Karnofsky performance score (KPS) ≥60 or KPS ≥40, but only caused by brain metastases. Exclusion Criteria: Patients with prior intracranial local treatments, such as surgery and radiotherapy without dose prescription in detail Patients with leptomeningeal metastases at first diagnosis. Had synchronous or metachronous malignancies that might affect survival. Had severe systemic diseases, abnormal conditions that might lead to incoordinate behavior during the implementation of clinical measures. Had incomplete sociodemographic and/or clinicopathologic baseline data

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| The upfront radiotherapy group<br> | |
| The upfront targeted-therapy group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intracranial progression-free survival | The survival time of patients before any intracranial progression | The interval from the start of initial intracranial treatment to first documented intracranial progression, or date of death from any cause, whichever came first, assessed up to 3 to 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival | The survival time of patients | The time from the date of initial intracranial treatment until death from any cause or censored on the last follow-up, whichever came first, assessed up to 3 to 5 years | 
| Brain metastasis-specific survival | The survival time of patients dead from brain metastases | The interval from the start of initial intracranial treatment to death from brain metastases or censored on the last follow-up, whichever came first, assessed up to 3 to 5 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Brain metastases, Radiotherapy, Targeted therapy