Survival Outcomes in Patients with Brain Metastases Treated with Whole Brain Radiotherapy
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Date
2025
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Addis Ababa Uinverstiy
Abstract
Introduction: Brain metastases are the most common intracranial tumors in adults and are associated with poor prognosis. In low resource settings such as Ethiopia, whole brain radiotherapy (WBRT) remains the primary treatment option for most patients due to limited access to stereotactic radiosurgery and neurosurgical services. However local evidence regarding survival outcomes and prognostic factors following WBRT is scarce.
Objective : To assess overall survival and identify prognostic factors influencing survival among patients with brain metastases treated with whole brain radiotherapy at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods : A retrospective study was conducted among adult patients with radiologically confirmed brain metastases who received WBRT between April 2020 and April 2024. Data were extracted from medical records and radiotherapy logs using a standardized checklist. Overall survival was estimated using the Kaplan Meier method and group comparisons were performed using the log rank test. Univariable and multivariable Cox proportional hazards regression analyses were employed to identify independent predictors of survival.
Results : A total of 70 patients were included in the analysis. The median overall survival from initiation of WBRT was 4.7 months (95% CI: 3.7–5.7). The 6 month and 12month overall survival rates were 38% and 14%, respectively. On multivariable analysis, Karnofsky Performance Status (KPS) ≥70 was independently associated with improved survival, while delays in initiating WBRT beyond four weeks from diagnosis of brain metastases were associated with significantly worse survival outcomes.
Conclusion : Survival outcomes for patients with brain metastases treated with WBRT at Tikur Anbessa Specialized Hospital remain poor. Performance status and timely initiation of radiotherapy are key determinants of survival. Strengthening early diagnosis, streamlining referral pathways and improving access to timely radiotherapy may improve outcomes in this resource limited setting.
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Brain Metastases, whole Brain Radiotherapy, overall Survival, Prognostic Factors, Ethiopia