Systemic inflammation response index predicts overall survival in patients undergoing stereotactic radiosurgery for brain metastasis from non-small cell lung cancer

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Abstract
This study aimed to evaluate the prognostic value of pre-treatment blood cell counts in patients with brain metastasis (BM) from non-small cell lung cancer (NSCLC) who were treated using linear accelerator (linac)-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator. Between January 2011 and November 2022, 271 consecutive patients underwent linac-based SRS/fSRT for BM from NSCLC. Thirty patients with insufficient blood test data during this period were excluded from this analysis. Thirty-five patients with steroid intake at the time point of the blood test and 18 patients with higher C-reactive protein were excluded. Thus, 188 patients were eventually enrolled in this study. The median follow-up period after SRS/fSRT was 21 months (range: 0–121 months), and the median survival time after SRS/fSRT was 19 months. Neutrophil–lymphocyte ratio ≥ 1.90, lymphocyte–monocyte ratio ≤ 1.67 and systemic inflammation response index (SIRI) ≥ 2.95 were unfavorable predictors of prognosis for patients who underwent SRS/fSRT for BM from NSCLC. Cox proportional-hazard multivariate analysis revealed that the SIRI was independent prognostic factors for increased risk of death. Thus, simple, less expensive, and routinely performed pre-treatment blood cell count measurements such as SIRI can predict the overall survival of patients treated with SRS/fSRT for BM from NSCLC.

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