Journals / Turkish Neurosurgery / 2020 / Cilt: 30 - Sayı: 6

Analysis of Survival of Patients with Brain Metastases According to Prognostic Indexes and Treatment Strategies

Pages
822–831
DOI
—
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AIM: To retrospectively evaluate the overall survival (OS) of patients with brain metastases (BMs) who had been treated with whole brain radiotherapy (WBRT) and Gamma Knife (GK) according to prognostic factors and prognostic index scores.

📌 3 Key Takeaways

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Objective & Hypothesis:AIM: To retrospectively evaluate the overall survival (OS) of patients with brain metastases (BMs) who had been treated with whole brain radiotherapy (WBRT) and Gamma Knife (GK) according to prognostic factors and prognostic index scores.
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Key Findings & Data:MATERIAL and METHODS: The study included 91 patients with BMs who had been treated with WBRT and/or GK between 2014 and 2017.
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Conclusion & Impact:Thus, our data suggest that the BS-BM is the most appropriate prognostic index.
🔬Design:Modeling & Simulation
📍Scope:2014 Verileri
⚙️Variables:Domain Parameters

Özet

AIM: To retrospectively evaluate the overall survival (OS) of patients with brain metastases (BMs) who had been treated with whole brain radiotherapy (WBRT) and Gamma Knife (GK) according to prognostic factors and prognostic index scores. MATERIAL and METHODS: The study included 91 patients with BMs who had been treated with WBRT and/or GK between 2014 and 2017. The patients with BMs were retrospectively evaluated regarding age, sex, Karnofsky Performance Status (KPS), recursive partitioning analysis (RPA) class, basic score for BM (BS-BM), Graded Prognostic Assessment (DS-GPA) index, primary tumour type, extracranial metastases, primary tumour control, number of BMs, and brain metastasectomy. A univariate analysis of the OS was performed using the Kaplan-Meier method, supplemented by the log-rank test. We also applied a multivariate survival analysis using the Cox regression model.RESULTS: The median OS for all patients with BMs was 6 months. Meanwhile, the median OSs for those with WBRT, GK, and WBRT-GK treatment were 6, 4, and 15 months, respectively (p=0.00). In the multivariate analysis, the female sex (p=0.030), brain metastasectomy (p=0.047), treatment with WBRT-GK (p=0.001), and the controlled primary tumour (p=0.007) significantly correlated with the OS. Furthermore, the BS-BM (p=0.022) was closely related with the OS compared to the RPA and DS-GPA in the multivariate analysis.CONCLUSION: The BS-BM was found to better predict the survival of patients with BMs according to the prognostic index scores in the multivariate analysis. Thus, our data suggest that the BS-BM is the most appropriate prognostic index.

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Cite This Article

SAGINC, H., BALTALARLI, P. B., SAĞTAŞ, E., COSKUN, M. E. (2020). Analysis of Survival of Patients with Brain Metastases According to Prognostic Indexes and Treatment Strategies. Turkish Neurosurgery, Cilt: 30 - Sayı: 6, 822–831. https://ajindex.com/articles/404348

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References (1)

  1. Andrews DW, Scott CB, Sperduto PW: Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: Phase III results of the RTOG 9508 randomised trial. Lancet 363:1665-1672, 2004 2. Aoyama H, Shirato H, Tago M: Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: A randomized controlled trial. JAMA 295:2483-2491, 2006 3. Baschnagel AM, Meyer KD, Peter YC: Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery Clinical article. Journal of Neurosurgery 119:1139–1144, 2013 4. Bhatnagar AK, Flickinger JC, Kondziolka D: Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys 64:898-903, 2006 5. Bowden G, Kano H, Caparosa E: Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer. J Neurosurg 122:766-772, 2015 6. Bradley KA, Mehta MP: Management of brain metastases. Semin Oncol 31:693-701, 2004 7. Chang EL, Wefel JS, Hess KR: Neurocognition in patients with brain metastases treated withradiosurgery or radiosurgery plus whole-brain irradiation: A randomised controlled trial. Lancet Oncol 10:1037-1044, 2009 8. Ebner DK, Gorovets D, Rava P: Patients with long-term control of systemic disease are a favorable prognostic group for treatment of brain metastases with stereotactic radiosurgery alone. World Neurosurg 98:266-272, 2017 9. Gao HX, Huang SG, Du JF: Comparison of prognostic indices in NSCLC patients with brain metastases after radiosurgery. International Journal of Biological Sciences 14(14):2065- 2072, 2018 10. Gaspar L, Scott C, Rotman M: Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745-751,1997 11. Gaspar LE, Scott C, Murray K: Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases. International Journal of Radiation Oncology* Biology* Physics 47:1001-1006, 2000 12. Greenspoon JN, Ellis PM, Pond G: Comparative survival in patients with brain metastases from non-small-cell lung cancer treated before and after implementation of radiosurgery. Curr Oncol 24:146-151, 2017 13. Gondi V, Pugh SL, Tome WA: Preservation of memory with conformal avoidance of the hippocampal neural stem cell compartment during whole-