Prognostic Analysis of Lung Cancer With Brain Metastases in Elderly Patients: A Multicenter Retrospective Study.

Objectives: To explore the prognostic factors affecting overall survival (OS) in patients aged ≥ 65 years with lung cancer BMs. Methods: In this multicenter retrospective study, 293 patients aged ≥ 65 years diagnosed with lung cancer BMs between 2010 and 2023 were included. We analyzed the correlation between clinical information, treatment methods, molecular data, and OS. Univariate and multivariate Cox regression models were used to identify risk factors, and Kaplan-Meier survival curves were constructed for analysis. Results: A total of 293 patients aged ≥ 65 years with lung cancer BMs were included (age mean [SD], 69.40 [4.04] years). Univariate analysis of 293 lung cancer patients aged ≥ 65 years with BMs showed that risk prognostic factors included pathological type (SCLC, hazard ratio [HR] = 2.221, 95% confidence interval [CI] = 1.531-3.224, p < 0.001), location of BMs (HR = 1.428, 95% CI = 1.045-1.951, p = 0.025), diagnosis KPS (HR = 0.693, 95% CI = 0.528-0.909, p = 0.008), and targeted therapy (HR = 0.610, 95% CI = 0.465-0.798, p < 0.001). Multivariate analysis showed that pathological type (SCLC, HR = 1.814, 95% CI = 1.230-2.676, p = 0.003), diagnosis KPS (HR = 0.726, 95% CI = 0.550-0.959, p = 0.024), and targeted therapy (HR = 0.008, 95% CI = 0.506-0.902, p = 0.008) were independent factors of OS in such patients. Conclusions: Pathological type, KPS, and targeted therapy significantly impact OS in elderly lung cancer BM patients. Targeted therapy may be a promising option for improving prognosis in this patient population. Trial Registration: ClinicalTrials.gov identifier: NCT05609162.