脑转移瘤（BM）是许多癌症发展过程中常见的事件，也是患者死亡的主要原因之一。立体定向放射外科手术（SRS）是一种有效的BM治疗方法。目前对SRS治疗后各种临床因素对局部控制（LC）和总生存期（OS）的预后影响仍不清楚。本研究的目的是回顾性地分析接受SRS治疗的患者的颅内进展无瘤生存期（iPFS）和OS，并探讨不同临床特征与患者预后之间的关系。我们收集了2018年至2021年期间在我们中心被诊断为BM并接受SRS治疗的患者的临床信息。使用R软件进行单因素和多因素Cox回归分析以及iPFS和OS的KM分析，以研究临床特征的预后效果。共有183名在我们中心接受SRS治疗的患者被纳入队列。所有患者的中位iPFS为8.87个月（95% CI 6.9-10.6），中位OS为16.5个月（95% CI 12.9-20.7）。BM数量≥5（HR 1.965 [95% CI 1.381-2.796]，p < 0.001，经FDR校正后p值<0.001）被发现是iPFS和OS较短的强预测指标。亚组分析显示，颅内累积肿瘤体积（CITV）≥2.14 cm³和数量≥5的患者iPFS（P < 0.001）和OS（P = 0.007）最短，相对于其他亚组。对于有5个以上BM的患者，SRS加全脑放疗（WBRT）可以实现更好的局部控制，相对于仅SRS组（P = 0.0357）。外周血炎症指标与BM患者的预后在单因素Cox分析中相关，但在多因素Cox分析中不相关。BM数量是BM患者的独立预后因子。CITV较大且BM数量较多的亚组预后最差。对于有5个以上BM的患者，SRS和WBRT的组合可以提高局部控制，但不能延长OS。© 2023年。意大利医学放射学学会。

Brain metastasis (BM) is a common event during the development of many cancers, and is also one of the main causes of death of patients. Stereotactic radiosurgery (SRS) is an effective treatment for BM. The prognostic effects of various clinical factors on local control (LC) and overall survival (OS) after SRS treatment are still unclear. The purpose of this study is to retrospectively analyze the intracranial progression free survival (iPFS) and OS of patients receiving SRS treatment, and explore the relationship between various clinical characteristics and patient prognosis.We collected the clinical information of patients who were diagnosed with BM and received SRS treatment in our center between 2018 and 2021. Univariate and multivariate Cox regression analysis and KM analysis for iPFS and OS were conducted in R software to investigate the prognostic effects of clinical characteristics.In total, 183 patients that received SRS in our center were enrolled in the cohort. The median iPFS for all patients was 8.87 months (95% CI 6.9-10.6), and the median OS was 16.5 months (95% CI 12.9-20.7). BM number >  = 5 (HR 1.965 [95% CI 1.381-2.796], p < 0.001, FDR-corrected p < 0.001) was found to be strong predictor for shorter iPFS and OS. Subgroup analysis showed that patients with cumulative intracranial tumor volume (CITV) >  = 2.14 cm3 and number >  = 5 had shortest iPFS (P < 0.001) and OS (P = 0.007), compared with other subgroups. For patients with more than 5 BMs, SRS plus whole brain radiotherapy (WBRT) could achieve better local control, compared with SRS alone group (P = 0.0357). Peripheral blood inflammation indicators were associated with the prognosis of BM patients in univariate Cox analysis, but not in multivariate Cox analysis.BM number is an independent prognostic factor for BM patients. The prognosis of patients in the subgroup with larger CITV and more BM is the worst. For patients with more than 5 BM, the combination of SRS and WBRT can improve the local control, but cannot prolong the OS.© 2023. Italian Society of Medical Radiology.