Abstract
PURPOSE: This study aimed to compare the efficacy of anlotinib plus whole-brain radiotherapy (WBRT) with that of WBRT alone in non-small cell lung cancer (NSCLC) patients with multiple brain metastases (BMs). METHODS: The clinical data of patients with NSCLC and multiple BMs who received WBRT between 2019 and 2022 were collected. The patients were assigned to anlotinib plus WBRT group and WBRT group according to the treatment used. RESULTS: A total of 64 patients were eligible for analysis; 21 were treated with anlotinib plus WBRT, and 43 were treated with WBRT. The anlotinib plus WBRT group had a greater proportion of patients who were young and had a better performance status and adenocarcinoma histology than did the WBRT group. The median follow-up time was 18.0 months. The median intracranial progression-free survival (iPFS) was significantly longer in the anlotinib plus WBRT group than in the WBRT group (12.9 months vs. 7.4 months, p = 0.004). The median overall survival (OS) was 14.6 months in the anlotinib plus WBRT group and 9.4 months in the WBRT group (p = 0.039). Considering death as a competing risk to intracranial progression, the 1-year cumulative incidence of intracranial progression in the anlotinib plus WBRT group (26.7%) was significantly lower than that in the WBRT group (64.3%) (p = 0.021). There was no significant difference in treatment-related toxicity between the anlotinib plus WBRT group and the WBRT group. CONCLUSION: Compared with WBRT alone, anlotinib plus WBRT might confer superior intracranial PFS for NSCLC patients with multiple BMs without increasing treatment-related toxicity.