Articles Vol. 67 No. 3 31/03/2026

QUALITY OF LIFE IN NON-SMALL CELL LUNG CANCER PATIENTS WITH BRAIN METASTASES AFTER TREATMENT WITH A COMBINATION OF GAMMA KNIFE RADIOSURGERY AND TKIs

Tran Duc Linh1,2,3,4, Nguyen Duc Lien5,6,7,8, Nguyen Van Ba1,2,3,4
1 Military Medical Academy
2 Military Hospital 175
3 Học viện Quân y
4 Bệnh viện Quân y 175
5 K Hospital
6 Hanoi Medical University
7 Bệnh viện K
8 Trường Đại học Y Hà Nội
DOI: 10.52163/yhc.v67i3.4600
12 Views
2 Downloads
Keywords
Quality of life, Gamma Knife radiosurgery, TKIs, NSCLC, brain metastases.
Abstract

Objectives: To evaluate the changes in quality of life (QoL) in non-small cell lung cancer (NSCLC) patients with brain metastases after treatment with a combination of Gamma Knife radiosurgery and TKIs.

Subjects and methods: A longitudinal, prospective descriptive study was conducted on 43 NSCLC patients with brain metastases who received Gamma Knife radiosurgery combined with TKIs from January 2023 to December 2024.

Results: At the 6-month follow-up, most aspects of QoL remained stable. Several functions and symptoms showed significant improvement, such as: emotional function, fatigue, insomnia, future uncertainty, and motor dysfunction (improvement > 10 points, p<0,05). Meanwhile, rash and hair loss increased significantly. Patients with a low Karnofsky score and neurological symptoms before treatment showed better improvement in cognitive and motor functions (p<0,05). Meanwhile, patients treated with first and second generation TKIs developed skin rash more frequently than those treated with third generation TKIs (p=0.03).

Conclusion: The QoL of NSCLC patients with brain metastases after treatment with combined Gamma Knife radiosurgery and TKIs was maintained stably, with several functions and symptoms showing significant improvement.

References
[1]
Vogelbaum MA, Brown PD, Messersmith H, Brastianos PK, Burri S, Cahill D, et al. Treatment for brain metastases: ASCO-SNO-ASTRO guideline. J Clin Oncol. 2022;40: 492-516. https://doi.org/10.1200/jco.21.02314. Google Scholar
[2]
Magnuson W. J., Lester-Coll N. H., Wu A. J., et al. Management of brain metastases in tyrosine kinase inhibitor–naïve epidermal growth factor receptor–mutant non–small-cell lung cancer: a retrospective multi-institutional analysis. Journal of clinical oncology. (2017);35 (10), 1070-1077. https://doi.org/10.1200/jco.2016.69.7144. Google Scholar
[3]
Chen E., Nguyen J., Zhang L., et al. Quality of life in patients with brain metastases using the EORTC QLQ-BN20 and QLQ-C30. Journal of Radiation Oncology, (2012), 1 (2), 179-186. https://doi.org/10.1016/j.ijrobp.2011.09.025. Google Scholar
[4]
Habets E. J., Dirven L., Wiggenraad R. G., et al. Neurocognitive functioning and health-related quality of life in patients treated with stereotactic radiotherapy for brain metastases: a prospective study. Neuro Oncol, (2016), 18 (3), 435-444. https://doi.org/10.1093/neuonc/nov186. Google Scholar
[5]
Skeie B. S., Eide G. E., Flatebo M., et al. Quality of life is maintained using Gamma Knife radiosurgery: a prospective study of a brain metastases patient cohort. J Neurosurg, (2017), 126 (3), 708-725. https://doi.org/10.3171/2015.10.jns15801. Google Scholar
[6]
Bragstad S., Flatebo M., Natvig G. K., et al. Predictors of quality of life and survival following Gamma Knife surgery for lung cancer brain metastases: a prospective study. J Neurosurg, (2018), 129 (1), 71-83. https://doi.org/10.3171/2017.2.jns161659. Google Scholar
[7]
Karlsson A. T., Hjermstad M. J., Aass N., et al. Patient-Reported Outcomes Before and After Radiotherapy for Brain Metastases-A Prospective Cohort Study of 239 Non-Small-Cell Lung Cancer Patients. Cancers (Basel), (2025), 17 (9). https://doi.org/10.3390/cancers17091529. Google Scholar
[8]
Carlson L. E., Zelinski E. L., Toivonen K. I., et al. Prevalence of psychosocial distress in cancer patients across 55 North American cancer centers. J Psychosoc Oncol, (2019), 37 (1), 5-21. https://doi.org/10.1080/07347332.2018.1521490. Google Scholar
[9]
Hồng N. T. T. Đánh giá chất lượng cuộc sống người bệnh ung thư phổi di căn não được điều trị xạ phẫu Gamma Knife tại bệnh viện K. Luận văn Thạc sỹ Y học, Trường Đại học Y Hà Nội, (2021). Google Scholar
[10]
Verhaak E., Schimmel W. C. M., Gehring K., et al. Health-related quality of life after Gamma Knife radiosurgery in patients with 1-10 brain metastases. J Cancer Res Clin Oncol, (2021), 147 (4), 1157-1167. https://doi.org/10.1007/s00432-020-03400-w. Google Scholar
[11]
Kirkpatrick J. P., Wang Z., Sampson J. H., et al. Defining the optimal planning target volume in image-guided stereotactic radiosurgery of brain metastases: results of a randomized trial. Int J Radiat Oncol Biol Phys, (2015), 91 (1), 100-108. https://doi.org/10.1016/j.ijrobp.2014.09.004. Google Scholar
[12]
Pham D. Q., Sheehan D. E., Sheehan K. A., et al. Quality of life after stereotactic radiosurgery for brain metastasis: an assessment from a prospective national registry. J Neurooncol, (2025), 171 (2), 383-391. https://doi.org/10.1007/s11060-024-04854-5. Google Scholar