The effect of hypertension on survival in patients undergoing radiotherapy for brain metastasis

Objective: The prognosis of brain metastasis is very poor and the survival period is very short if the patient is not treated. The determination of prognostic factors is important in order to avoid invasive treatment interventions or unnecessary treatment in the management of patients with brain metastases. In this study, prognostic factors and the effect of hypertension on survival in patients with brain metastasis were investigated.Method: In this study, the data of 463 patients diagnosed with brain metastasis, who were admitted to Cumhuriyet University Radiation Oncology department between 2007 and 2018, were retrospectively analyzed.Results: The median age was 59 (18-82) years. There were 170 (37%) patients with comorbidity and 23% of these patients had hypertension in their medical history. With regard to primary cancer diagnoses, 271 (58%) patients had lung cancer, 91 (20%) breast, 31 (6%) gastrointestinal, 21 (5%) genitourinary, 13 (3%) gynecological, 11 (2%) unknown cancer and 25 (5%) had other types of cancer. At the time of diagnosis, 217 patients (47%) were in a metastatic stage. Median survival was 4 months (0-130 months); mean survival was 9.74 + 0.6 months; 1-year survival was 27% and 2-year survival was 13%. In univariate analysis, gender (p = .001), age (p < .001), hypertension (p = .018), primary diagnosis (p < .001), RPA (p < .001), number of lesions (p < .001), SRS (p < .001), metastatectomy (p < .001) and primary disease status (p = .002) were statistically significant. Multivariate analysis showed that hypertension (HR: 1.29, 95%; CI: 1.02-1.71;                       p =  .027), age (HR: 1.39, 95%; CI: 1.08-1.77; p = .008), primary diagnosis (HR: 1.63, 95%; CI: 1.20 -2.23; p = .002), RPA (HR: 2.05, 95%; CI: 1.35-3.09; p = .001), metastatectomy (HR: 0.63, 95%; CI: 0.46-0.86; p = .004) and SRS (HR: 0.53, 95%; CI: 0.38-0.72, p < .001) were independent prognostic factors. Conclusions: In this study, the presence of hypertension was as important in the prognosis of the disease as primary diagnosis, age, metastatectomy and SRS.

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