Skip to main content
Erschienen in: Strahlentherapie und Onkologie 9/2013

01.09.2013 | Original article

A new survival score for patients with brain metastases from non-small cell lung cancer

verfasst von: D. Rades, M.D., L. Dziggel, B. Segedin, MD, I. Oblak, MD, V. Nagy, MD, PhD, A. Marita, MD, S.E. Schild, MD, N.T. Trang, MD, M.T. Khoa, MD, PhD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Background and purpose

Non-small cell lung cancer (NSCLC) is the most common primary tumor in patients developing brain metastasis. This study was performed to develop and validate a survival score particularly for this group of patients.

Patients and methods

In this study, the data of 514 patients treated with whole-brain radiotherapy (WBRT) alone for brain metastasis from NSCLC were retrospectively analyzed. The patients were divided into a test group (n = 257) and a validation group (n = 257). In the multivariate analysis of the test group, gender, performance status, and extracranial metastases were independent predictors of survival and, therefore, included in the scoring system. The score for each of the three factors was obtained from the 6-month survival rate (in %) divided by 10. The total scores that represented the sum of the three scores were 5, 8, 9, 11, 12, or 15 points. Three prognostic groups were formed according to the total scores.

Results

The 6-month survival rates in the test group were 9 % for 5–9 points (group A), 54 % for 11–12 points (group B), and 79 % for 15 points (group C). In the validation group the 6-month survival rates were 14, 56, and 78 %, respectively. The comparisons between the prognostic groups A, B, and C of the test and the validation group did not reveal any significant differences.

Conclusion

This new score appears valid and reproducible. It can help predict the survival of patients with brain metastasis from NSCLC.
Literatur
1.
Zurück zum Zitat Chiou SM (2013) Survival of brain metastatic patients treated with gamma knife radiosurgery alone. Clin Neurol Neurosurg 115:276–284CrossRef Chiou SM (2013) Survival of brain metastatic patients treated with gamma knife radiosurgery alone. Clin Neurol Neurosurg 115:276–284CrossRef
2.
Zurück zum Zitat DeAngelis LM, Delattre JY, Posner JB (1989) Radiation-induced dementia in patients cured of brain metastases. Neurology 39:789–796PubMedCrossRef DeAngelis LM, Delattre JY, Posner JB (1989) Radiation-induced dementia in patients cured of brain metastases. Neurology 39:789–796PubMedCrossRef
3.
Zurück zum Zitat Gaspar L, Scott C, Rotman M et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751PubMedCrossRef Gaspar L, Scott C, Rotman M et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751PubMedCrossRef
4.
Zurück zum Zitat Heery CR, Engelhard HH, Slavin KV et al (2012) Unusual presentation of thyroid cancer. Clin Neurol Neurosurg 114:1107–1109PubMedCrossRef Heery CR, Engelhard HH, Slavin KV et al (2012) Unusual presentation of thyroid cancer. Clin Neurol Neurosurg 114:1107–1109PubMedCrossRef
5.
Zurück zum Zitat Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef
6.
Zurück zum Zitat Khuntia D, Brown P, Li J et al (2006) Whole-brain radiotherapy in the management of brain metastases. J Clin Oncol 24:1295–1304PubMedCrossRef Khuntia D, Brown P, Li J et al (2006) Whole-brain radiotherapy in the management of brain metastases. J Clin Oncol 24:1295–1304PubMedCrossRef
7.
Zurück zum Zitat Marko NF, Weil RJ (2010) Radiotherapy. Neurocognitive considerations in the treatment of brain metastases. Nat Rev Clin Oncol 7:185–186PubMedCrossRef Marko NF, Weil RJ (2010) Radiotherapy. Neurocognitive considerations in the treatment of brain metastases. Nat Rev Clin Oncol 7:185–186PubMedCrossRef
8.
Zurück zum Zitat Mut M (2012) Surgical treatment of brain metastasis: a review. Clin Neurol Neurosurg 114:1–8PubMedCrossRef Mut M (2012) Surgical treatment of brain metastasis: a review. Clin Neurol Neurosurg 114:1–8PubMedCrossRef
9.
Zurück zum Zitat Nieder C, Andratschke NH, Geinitz H et al (2012) Use of the Graded Prognostic Assessment (GPA) score in patients with brain metastases from primary tumours not represented in the diagnosis-specific GPA studies. Strahlenther Onkol 188:692–695PubMedCrossRef Nieder C, Andratschke NH, Geinitz H et al (2012) Use of the Graded Prognostic Assessment (GPA) score in patients with brain metastases from primary tumours not represented in the diagnosis-specific GPA studies. Strahlenther Onkol 188:692–695PubMedCrossRef
10.
Zurück zum Zitat Nieder C, Astner ST, Andratschke NH, Marienhagen K (2011) Postoperative treatment and prognosis of patients with resected single brain metastasis: how useful are established prognostic scores? Clin Neurol Neurosurg 113:98–103PubMedCrossRef Nieder C, Astner ST, Andratschke NH, Marienhagen K (2011) Postoperative treatment and prognosis of patients with resected single brain metastasis: how useful are established prognostic scores? Clin Neurol Neurosurg 113:98–103PubMedCrossRef
11.
Zurück zum Zitat Rades D, Bohlen G, Dunst J et al (2008) Comparison of short-course versus long-course whole-brain radiotherapy in the treatment of brain metastases. Strahlenther Onkol 184:30–35PubMedCrossRef Rades D, Bohlen G, Dunst J et al (2008) Comparison of short-course versus long-course whole-brain radiotherapy in the treatment of brain metastases. Strahlenther Onkol 184:30–35PubMedCrossRef
12.
Zurück zum Zitat Rades D, Küter JD, Gliemroth J et al (2012) Resection plus whole-brain irradiation versus resection plus whole-brain irradiation plus boost for the treatment of single brain metastasis. Strahlenther Onkol 188:143–147PubMedCrossRef Rades D, Küter JD, Gliemroth J et al (2012) Resection plus whole-brain irradiation versus resection plus whole-brain irradiation plus boost for the treatment of single brain metastasis. Strahlenther Onkol 188:143–147PubMedCrossRef
13.
Zurück zum Zitat Rades D, Küter JD, Meyners T et al (2012) Single brain metastasis: resection followed by whole-brain irradiation and a boost to the metastatic site compared to whole-brain irradiation plus radiosurgery. Clin Neurol Neurosurg 114:326–330PubMedCrossRef Rades D, Küter JD, Meyners T et al (2012) Single brain metastasis: resection followed by whole-brain irradiation and a boost to the metastatic site compared to whole-brain irradiation plus radiosurgery. Clin Neurol Neurosurg 114:326–330PubMedCrossRef
14.
Zurück zum Zitat Rades D, Panzner A, Dziggel L et al (2012) Dose-escalation of whole-brain radiotherapy for brain metastasis in patients with a favorable survival prognosis. Cancer 118:3852–3859PubMedCrossRef Rades D, Panzner A, Dziggel L et al (2012) Dose-escalation of whole-brain radiotherapy for brain metastasis in patients with a favorable survival prognosis. Cancer 118:3852–3859PubMedCrossRef
15.
Zurück zum Zitat Ruge MI, Kocher M, Maarouf M et al (2011) Comparison of stereotactic brachytherapy (125 iodine seeds) with stereotactic radiosurgery (LINAC) for the treatment of singular cerebral metastases. Strahlenther Onkol 187:7–14PubMedCrossRef Ruge MI, Kocher M, Maarouf M et al (2011) Comparison of stereotactic brachytherapy (125 iodine seeds) with stereotactic radiosurgery (LINAC) for the treatment of singular cerebral metastases. Strahlenther Onkol 187:7–14PubMedCrossRef
Metadaten
Titel
A new survival score for patients with brain metastases from non-small cell lung cancer
verfasst von
D. Rades, M.D.
L. Dziggel
B. Segedin, MD
I. Oblak, MD
V. Nagy, MD, PhD
A. Marita, MD
S.E. Schild, MD
N.T. Trang, MD
M.T. Khoa, MD, PhD
Publikationsdatum
01.09.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 9/2013
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0362-x

Weitere Artikel der Ausgabe 9/2013

Strahlentherapie und Onkologie 9/2013 Zur Ausgabe

Mitteilungen der Fachgesellschaften

Mitteilungen der Fachgesellschaften

Update Onkologie

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