Table 1.
Baseline clinical and MRI characteristics
| Items | All patients (n=62) |
Group 1 ICI alone (n=10) |
Group 2 Stereotactic radiotherapy without or with non-ICI pharmacotherapy (n=20) |
Group 3 ICI plus stereotactic radiotherapy (n=32) |
| Age at BM diagnosis (years): median (IQR) | 58 (45–68) | 58 (47–71) | 55 (43–63) | 58 (51–69) |
| KPS at BM diagnosis (n, %) | ||||
| 90-100 | 35 (56) | 6 (60) | 13 (65) | 16 (50) |
| 70-80 | 25 (40) | 4 (40) | 7 (35) | 14 (44) |
| <70 | 2 (3) | 0 (0) | 0 (0) | 2 (6) |
| Median KPS (IQR) | 90 (80–100) | 95 (80–100) | 90 (80–100) | 85 (80–92) |
| Time interval between diagnosis of melanoma and diagnosis of BM in months: median (IQR) | 23 (9–43) | 22 (15–25) | 19 (13–40) | 28 (7–50) |
| New metastatic sites outside CNS at BM diagnosis | 30 (48) (3 n=59) | 6 (60) (n=10) | 9 (45) (1 n=9) | 15 (47) (2 n=30) |
| Symptoms and signs (n, %) | ||||
| Seizures | 9 (14) | 0 | 2 (10) | 7 (22) |
| Paresis | 15 (24) | 0 | 3 (15) | 12 (37) |
| Aphasia | 7 (11) | 0 | 0 (0) | 7 (22) |
| Visual disturbance | 4 (6) | 0 | 0 (0) | 4 (12) |
| Sensory deficits | 8 (13) | 0 | 3 (15) | 5 (16) |
| Headache | 14 (23) (n=31) | 0 | 7 (35) | 7 (22) (n=31) |
| Psychiatric and cognitive disorders | 8 (13) | 0 | 2 (10) | 6 (19) |
| Cerebellar and brainstem symptoms | 1 (2) (n=30) | 0 | 1 (5) (n=9) | 0 (0) (n=31) |
| Other symptoms | 1 (2) (n=31) | 0 | 0 (0) (n=9) | 1 (3) |
| Asymptomatic | 31 (50) | 10 (100) | 8 (40) | 13 (41) |
| LDH level at BM diagnosis (n, %) | ||||
| Elevated | 14 (23) | 3 (30) | 5 (25) | 6 (19) |
| Normal | 36 (58) | 6 (60) | 8 (40) | 22 (69) |
| No data | 12 (19) | 1 (10) | 7 (35) | 4 (12) |
| Median LDH level (IQR) | 326 (251–449) (n=43) | 262 (197–353) (n=7) | 397 (284–492) (n=11) | 321 (268–412) (n=25) |
| DS-GPA at BM diagnosis: median (IQR) | 2 (1.5-.2.5) | 1.75 (1.1–2.4) | 2.5 (1.5–3) | 2 (1.5–2.5) |
| Number of BM (n, %) | ||||
| 1 | 34 (55) | 4 (40) | 14 (70) | 16 (50) |
| 2 | 13 (21) | 0 (0) | 2 (10) | 11 (34) |
| 3 | 6 (10) | 1 (10) | 3 (15) | 2 (6) |
| 4 | 1 (2) | 1 (10) | 0 (0) | 0 (0) |
| 5 | 2 (3) | 1 (10) | 0 (0) | 1 (3) |
| >5 | 6 (10) | 3 (30) | 1 (5) | 2 (6) |
| Median (IQR) | 1 (1–2) | 3.5 (1.5–5.75) | 1 (1–2) | 1.5 (1–2) |
| Maximum diameter of largest BM: median (IQR) | 18 (13–25) | 13 (10–15) | 21 (17–24) | 18 (14–25) |
| BM with a maximal diameter >30 mm (n, %) | 9 (14) | 0 | 5 (25) | 4 (12)) |
| Necrotic BM (n, %) | 6 (10) (n=59) | 0 (n=9) | 3 (15) (n=19) | 3 (9) (n=31) |
| Cystic BM (n, %) | 8 (13) (n=61) | 0 (n=9) | 2 (10) (n=20) | 6 (19) (n=32) |
| Haemorrhagic BM (n, %) | 19 (31) (n=58) | 1 (11) (n=9) | 5 (25) (n=18) | 13 (41) (n=31) |
| Significant oedema (n, %) | 42 (68) (n=59) | 5 (50) (n=10) | 14 (70) (n=17) | 23 (72) (n=32) |
| Oedema, mm: median (IQR) | 10.5 (1.5–17) (n=54) | 0 (0–5.5) (n=7) | 18 (10–25) (n=17) | 10 (2–14) (n=30) |
The number of patients is given when not all the data are available.
*Two patients had multiple brain metastases and were considered with 10 metastases.
BM, brain metastases; CNS, central nervous system; DS-GPA, diagnosis-specific graded prognostic assessment; ICI, immune checkpoint inhibition; KPS, Karnofsky Performance Score; LDH, lactate dehydrogenase; n, number of patients.