SURVIVAL AND QUALITY OF LIFE IN PATIENTS WITH BRAIN METASTASIS AFTER PALLIATIVE RADIOTHERAPY TO THE BRAIN IN LAGOS STATE, NIGERIA

Background: Brain Metastases are a devastating complication of Cancer affecting 20-40% of patients with systemic disease. Patients with brain metastasis have limited survival; therefore, improving the quality of life of the patient is the primary goal of treatment by employing treatment with minimal complications. Aims: To assess median survival and the quality of life of patients who received Whole Brain Radiotherapy for Brain Metastases. Methods: Patients with radiologically confirmed brain metastasis who had whole brain radiotherapy between March 2021 and February 2022 at Lagos University Teaching Hospital and Eko Hospital in Nigeria were recruited. Overall survival at 6 months was estimated using Kaplan-Meier survival curve and compared using log-rank test. Cox regression analysis was used to identify independent predictors of mortality (sex, stage of primary disease at diagnosis, number of metastases and size of metastasis). Quality of life was assessed using FACT-Br questionnaire at baseline and monthly, till 6 months. Results: A total of 25 patients were recruited. The mean age was 48.12±12.9 years, and a higher proportion of the participants were females (92.0%). Common clinical features of brain metastasis were headaches (68.0%), motor deficits (52.0%), seizures (32.0%), speech abnormalities (32.0%), irrational behavior (30.0%) and loss of consciousness (30.0%). Breast cancer was the most common primary malignancy (88.0%), and just over half of the patients (56.0%) presented with locally advanced or metastatic disease. Most of the brain metastases were located in the cerebrum (76.0%) and cerebellum (48.0%). Over half of the patients had more than 2 brain metastases (56.0%), and the size of the brain metastasis was > 5cm in 36.0% of the participants. The Kaplan-Meier estimated overall survival at 6 months post diagnosis of brain metastasis was 30.0% and the median time to death post diagnosis of brain metastasis was 2 months. The overall quality of life score was better at 6 months compared to baseline (132.5 vs 105.0). Conclusion: The overall survival of patients with brain metastasis at 6 months post diagnosis was 30.0%, with a median overall survival of 2 months. Whole-brain radiotherapy was beneficial to the patients who were alive at 6 months as indicated by improved quality of life.