nach oben

Erschienen in:

28.05.2019 | Clinical Study

Applicability and limitations of a recently-proposed prognostic grading metric, initial brain metastasis velocity, for brain metastasis patients undergoing stereotactic radiosurgery

verfasst von: Masaaki Yamamoto, Hitoshi Aiyama, Takao Koiso, Shinya Watanabe, Takuya Kawabe, Yasunori Sato, Yoshinori Higuchi, Hidetoshi Kasuya, Bierta E. Barfod

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study, based on our brain metastasis (BM) patients undergoing stereotactic radiosurgery (SRS) procedures, aimed to validate whether the recently-proposed prognostic grading system, initial brain metastasis velocity (iBMV, scoring the cumulative number of BMs at the time of SRS divided by time [years] since the initial primary cancer diagnosis), is generally applicable.

Methods

This was an institutional review board-approved, retrospective cohort study using our prospectively accumulated database including 3498 patients who underwent SRS for BMs during the 19.5-year-period between July, 1998 and December, 2017. We excluded four lost to follow-up, 24 for whom the day of primary cancer diagnosis was not available, 665 with synchronous presentation and 651 with pre-SRS radiotherapy and/or surgery, ultimately studying 2150 patients. Patients were categorized into two classes by iBMV scores, i.e., < 2.00 and ≥ 2.00.

Results

In a multivariable model, iBMV was directly associated with a higher risk of death (p < 0.0001). The median survival time of patients with iBMV scores < 2.00, 10.0 (95% CI; 9.2–10.9) months, was longer than that of patients with iBMV scores ≥ 2.00, 6.3 (5.6–6.7) months, showing a significant difference between the two groups (HR 1.599, 95% CI 1.458–1.753, p < 0.0001). The same results were obtained in patients with non-small cell lung, breast, kidney or other cancers. Among 608 patients who underwent repeat SRS for newly-developed BMs, iBMV score categories correlated well with brain metastasis velocity risk groups (p < 0.0001).

Conclusions

Our present results support the validity of iBMV for predicting survival after SRS.

The National Comprehensive Cancer Network Clinical Practice Guideline in Oncology, Central Nervous System Cancers, Version 2.2018. Accessed on December 5, 2018 https://www.nccn.org/professionals/physician_gls/pdf/cns.pdf

Yamamoto M, Serizawa T, Shuto T et al (2014) (2014) Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol 15:387–395. https://doi.org/10.1016/S1470-2045(14)70061-0 CrossRefPubMed

Yamamoto M, Kawabe T, Sato Y et al (2013) A case-matched study of stereotactic radiosurgery for patients with multiple brain metastases: comparing treatment results for 1–4 vs ≥5 tumors. J Neurosurg 118:1258–1268. https://doi.org/10.3171/2013.3.JNS121900 CrossRefPubMed

Serizawa T, Higuchi Y, Nagano O et al (2017) Robustness of the neurological prognostic score in brain metastasis patients treated with Gamma Knife radiosurgery. J Neurosurg 127:1000–1006. https://doi.org/10.3171/2016.8.JNS16528 CrossRefPubMed

Hanssens P, Karlsson B, Yeo TT, Chou N, Beute G (2011) Detection of brain micrometastases by high-resolution stereotactic magnetic resonance imaging and its impact on the timing of and risk for distant recurrences. J Neurosurg 115:499–504. https://doi.org/10.3171/2011.4.JNS101832 CrossRefPubMed

Weltman E, Salvajoli JV, Brandt RA et al (2000) Radiosurgery for brain metastases: a score index for predicting prognosis. Int J Radiat Oncol Biol Phys 46:1155–1161CrossRefPubMed

Sperduto PW, Chao ST, Sneed PK et al (2010) Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 77:655–661. https://doi.org/10.1016/j.ijrobp.2009.08.025 CrossRefPubMed

Yamamoto M, Sato Y, Serizawa T et al (2012) Subclassification of recursive partitioning analysis class II patients with brain metastases treated radiosurgically. Int J Radiat Oncol Biol Phys 83:1399–1405. https://doi.org/10.1016/j.ijrobp.2011.10.018 CrossRefPubMed

Yamamoto M, Serizawa T, Sato Y et al (2013) Validity of two recently-proposed prognostic grading indices for lung, gastro-intestinal, breast and renal cell cancer patients with radiosurgically-treated brain metastases. J Neurooncol 111:327–335. https://doi.org/10.1007/s11060-012-1019-9 CrossRefPubMed

10.

Soike MH, McTyre ER, Hughes RT et al (2018) Initial brain metastasis velocity: does the rate at which cancers first seed the brain affect outcomes? J Neurooncol 139:461–467. https://doi.org/10.1007/s11060-018-2888-3 CrossRefPubMed

11.

Farris M, McTyre ER, Cramer CK et al (2017) Brain metastasis velocity: a novel prognostic metric predictive of overall survival and freedom from whole-brain radiation therapy after distant brain failure following upfront radiosurgery alone. Int J Radiat Oncol Biol Phys 98:131–141. https://doi.org/10.1016/j.ijrobp.2017.01.201 CrossRefPubMed

12.

Yamamoto M, Aiyama H, Koiso T et al (2018) Validity of a recently proposed prognostic grading index, brain metastasis velocity, for patients with brain metastasis undergoing multiple radiosurgical procedures. Int J Radiat Oncol Biol Phys 103:631–637. https://doi.org/10.1016/j.ijrobp.2018.10.036 CrossRefPubMed

13.

Fine JP, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496–509. https://doi.org/10.1080/01621459.1999.10474144 CrossRef

14.

Gooley TA, Leisenring W, Crowley J, Storer BE (1999) Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 18:695–706CrossRefPubMed

15.

Niwińska A, Murawska M (2012) New breast cancer recursive partitioning analysis prognostic index in patients with newly diagnosed brain metastases. Int J Radiat Oncol Biol Phys 82:2065–2071. https://doi.org/10.1016/j.ijrobp.2010.10.077 CrossRefPubMed

16.

Sperduto PW, Chao ST, Sneed PK et al (2010) (2010) Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 77:655–661. https://doi.org/10.1016/j.ijrobp.2009.08.025 CrossRefPubMed

17.

Sperduto PW, Kased N, Roberge D et al (2013) The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer. J Neurooncol 112:467–472. https://doi.org/10.1007/s11060-013-1083-9 CrossRefPubMed

18.

Sperduto PW, Yang TJ, Beal K et al (2017) Estimating survival in patients with lung cancer and brain metastases: an update of the graded prognostic assessment for lung cancer using molecular markers (Lung-molGPA). JAMA Oncol 3:827–831. https://doi.org/10.1001/jamaoncol.2016.3834 CrossRefPubMed

Titel: Applicability and limitations of a recently-proposed prognostic grading metric, initial brain metastasis velocity, for brain metastasis patients undergoing stereotactic radiosurgery
verfasst von: Masaaki Yamamoto
Hitoshi Aiyama
Takao Koiso
Shinya Watanabe
Takuya Kawabe
Yasunori Sato
Yoshinori Higuchi
Hidetoshi Kasuya
Bierta E. Barfod
Publikationsdatum: 28.05.2019
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03199-8

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2019

Association of MRI findings with clinical characteristics and prognosis in patients with leptomeningeal carcinomatosis from non-small cell lung cancer

Spinal location is prognostic of survival for solitary-fibrous tumor/hemangiopericytoma of the central nervous system

Gliosarcoma: distinct molecular pathways and genomic alterations identified by DNA copy number/SNP microarray analysis

Hypofractionated radiation therapy versus chemotherapy with temozolomide in patients affected by RPA class V and VI glioblastoma: a randomized phase II trial

Cost-effectiveness of tumor-treating fields added to maintenance temozolomide in patients with glioblastoma: an updated evaluation using a partitioned survival model

Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature