脑转移瘤（BM）的伽玛刀手术（GKS）通常推荐给卡诺夫斯基综合评分（KPS）≥70的患者。然而，一些KPS评分<70的患者在接受GKS后能够康复并展示持久的生存。本研究的目的是设计一个3个月生存预测模型，以便筛选出需要进行GKS的KPS≤70的BM患者。我们对2016年至2020年间我院进行的67例KPS评分为60-70的非小细胞肺癌（NSCLC）BM患者进行了回顾性分析。进行了单变量和多变量 logistic 回归分析，以考察与进行GKS后3个月以上生存相关的因素。根据各变量的比值比（odds ratio），设计了概率（P）预测模型，并赋予变量相应的权重。总体生存时间为9.9±12.7个月（范围0.2-53.2个月），3个月生存率为59.7%（n=40）。多变量 logistic 回归分析结果显示，颅外疾病（ECD）控制（p=.033）、局灶性神经系统缺陷（FND）（p=.014）和累积肿瘤体积（∑ TV）（p=.005）与3个月生存相关。根据相关因素设计了3个月生存预测模型（Harrell's C指数=0.767）。总之，即使KPS评分≤70，也建议对选择患者进行BM的伽玛刀手术（GKS）。© 2023. Springer Nature Limited.

Gamma Knife surgery (GKS) for brain metastasis (BM) has been generally advocated for patients with a Karnofsky performance status (KPS) scale of ≥ 70. However, some patients with a poor KPS scale of < 70 are recoverable after GKS and show durable survival. A purpose of this study is to devise a 3-month survival prediction model to screen patients with BM with a KPS of ≤ 70 in whom GKS is needed. A retrospective analysis of 67 patients with a KPS scale of 60-70 undergoing GKS for BM of non-small cell lung cancer (NSCLC) from 2016 to 2020 in our institute was performed. Univariate and multivariate logistic regression analyses were performed to investigate factors related to survival for more than 3 months after GKS. The probability (P) prediction model was designed by giving a weight corresponding to the odds ratio of the variables. The overall survival was 9.9 ± 12.7 months (range 0.2-53.2), with a 3-month survival rate of 59.7% (n = 40). In multivariate logistic regression analysis, extracranial disease (ECD) control (p = .033), focal neurological deficit (FND) (p = .014), and cumulative tumor volume (∑ TV) (p = .005) were associated with 3-month survival. The prediction model of 3-month survival (Harrell's C index = 0.767) was devised based on associated factors. In conclusion, GKS for BMs is recommended in selected patients, even if the KPS scale is ≤ 70.© 2023. Springer Nature Limited.