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Erschienen in: Strahlentherapie und Onkologie 1/2014

01.01.2014 | Original article

A survival score for patients with brain metastases from less radiosensitive tumors treated with whole-brain radiotherapy alone

verfasst von: L. Dziggel, B. Segedin, N.H. Podvrsnik, I. Oblak, S.E. Schild, D. Rades, M.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2014

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Abstract

Background and purpose

This study aimed to develop and validate a scoring system to predict the survival of patients receiving whole-brain radiotherapy (WBRT) alone for brain metastases from less radiosensitive tumors.

Patients and methods

The study included data from 176 patients with brain metastasis from renal cell carcinoma, malignant melanoma or colorectal cancer. Patients were divided into a test group (N = 88) and a validation group (N = 88). In the multivariate analysis of the test group, age, Karnofsky Performance Status and extracranial metastasis were significantly associated with survival. These three factors were included in the scoring system. The score for each factor was determined by dividing the 6-month survival rate (in %) by 10. The total score represented the sum of the three scores. According to the total scores—which ranged from 5 to14 points—three prognostic groups were created.

Results

The 6-month survival rates in the test group were 11 % for 5–8 points (N = 47, group A), 38 % for 9–11 points (N = 29, group B) and 83 % for 12–14 points (N = 12, group C). In the validation group the 6-month survival rates were 12, 31  and 75 %, respectively. Comparisons between the prognostic groups A, B and C of the test group with those of the validation group did not reveal any significant differences.

Conclusion

The new scoring system based on three independent prognostic factors can help to estimate the survival of patients with brain metastases from a less radiosensitive tumor. The score appears to be valid and reproducible.
Literatur
1.
Zurück zum Zitat Culine S, Bekradda M, Kramar A et al (1998) Prognostic factors for survival in patients with brain metastases from renal cell carcinoma. Cancer 83:2548–2553PubMedCrossRef Culine S, Bekradda M, Kramar A et al (1998) Prognostic factors for survival in patients with brain metastases from renal cell carcinoma. Cancer 83:2548–2553PubMedCrossRef
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 Heisterkamp C, Haatanen T, Schild SE, Rades D (2010) Dose escalation in patients receiving whole-brain radiotherapy for brain metastases from colorectal cancer. Strahlenther Onkol 186:70–75PubMedCrossRef Heisterkamp C, Haatanen T, Schild SE, Rades D (2010) Dose escalation in patients receiving whole-brain radiotherapy for brain metastases from colorectal cancer. Strahlenther Onkol 186:70–75PubMedCrossRef
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 Kruser TJ, Chao ST, Elson P et al (2008) Multidisciplinary management of colorectal brain metastases. A retrospective study. Cancer 113:158–165PubMedCrossRef Kruser TJ, Chao ST, Elson P et al (2008) Multidisciplinary management of colorectal brain metastases. A retrospective study. Cancer 113:158–165PubMedCrossRef
8.
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
9.
Zurück zum Zitat Meyners T, Heisterkamp C, Kueter JD et al (2010) Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis. BMC Cancer 10:582PubMedCentralPubMed Meyners T, Heisterkamp C, Kueter JD et al (2010) Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis. BMC Cancer 10:582PubMedCentralPubMed
10.
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
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, Evers JN, Veninga T et al (2011) Shorter-course whole-brain radiotherapy for brain metastases in elderly patients. Int J Radiat Oncol Biol Phys 81:e469–e473PubMedCrossRef Rades D, Evers JN, Veninga T et al (2011) Shorter-course whole-brain radiotherapy for brain metastases in elderly patients. Int J Radiat Oncol Biol Phys 81:e469–e473PubMedCrossRef
13.
Zurück zum Zitat Rades D, Heisterkamp C, Huttenlocher S et al (2010) Dose escalation of whole-brain radiotherapy for brain metastases from melanoma. Int J Radiat Oncol Biol Phys 77:537–541PubMedCrossRef Rades D, Heisterkamp C, Huttenlocher S et al (2010) Dose escalation of whole-brain radiotherapy for brain metastases from melanoma. Int J Radiat Oncol Biol Phys 77:537–541PubMedCrossRef
14.
Zurück zum Zitat Rades D, Heisterkamp C, Schild SE (2010) Do patients receiving whole-brain radiotherapy for brain metastases from renal cell carcinoma benefit from escalation of the radiation dose? Int J Radiat Oncol Biol Phys 78:398–403PubMedCrossRef Rades D, Heisterkamp C, Schild SE (2010) Do patients receiving whole-brain radiotherapy for brain metastases from renal cell carcinoma benefit from escalation of the radiation dose? Int J Radiat Oncol Biol Phys 78:398–403PubMedCrossRef
15.
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
16.
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
17.
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
18.
Zurück zum Zitat 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 77:655–661PubMedCrossRef 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 77:655–661PubMedCrossRef
19.
Zurück zum Zitat Tan WS, Ho KS, Eu KW (2009) Brain metastases in colorectal cancers. World J Surg 33:817–821PubMedCrossRef Tan WS, Ho KS, Eu KW (2009) Brain metastases in colorectal cancers. World J Surg 33:817–821PubMedCrossRef
20.
Zurück zum Zitat Tsao MN, Lloyd N, Wong RK et al (2012) Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev 18:4(CD003869) Tsao MN, Lloyd N, Wong RK et al (2012) Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev 18:4(CD003869)
Metadaten
Titel
A survival score for patients with brain metastases from less radiosensitive tumors treated with whole-brain radiotherapy alone
verfasst von
L. Dziggel
B. Segedin
N.H. Podvrsnik
I. Oblak
S.E. Schild
D. Rades, M.D.
Publikationsdatum
01.01.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 1/2014
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0394-2

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