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A New Tool to Predict Survival after Radiosurgery Alone for Newly Diagnosed Cerebral Metastases

2015; West Asia Organization for Cancer Prevention; Volume: 16; Issue: 7 Linguagem: Inglês

10.7314/apjcp.2015.16.7.2967

2476-762X

Dirk Rades, Stefan Huttenlocher, Liesa Dziggel, Oliver Blanck, Dagmar Hornung, Khoa Trong, Trang Thuy Ngo, Thai V. Pham, Steven E. Schild,

Glioma Diagnosis and Treatment

Many patients with few cerebral metastases receive radiosurgery alone. The goal of this study was to create a tool to estimate the survival of such patients. To identify characteristics associated with survival, nine variables including radiosurgery dose, age, gender, Eastern cooperative oncology group performance score (ECOG-PS), primary tumor type, number/size of cerebral metastases, location of cerebral metastases, extra-cerebral metastases and time between cancer diagnosis and radiosurgery were analyzed in 214 patients. On multivariate analysis, age (p=0.03), ECOG-PS (p=0.02) and extra-cerebral metastases (p<0.01) had significant impacts on survival. Scoring points for each patient were obtained from 12-month survival rates (in %) related to the significant variables divided by 10. Addition of the scoring points of the three variables resulted in a patient's total predictive score. Two groups were designed, A (10-14 points) and B (16-17 points). Twelve-month survival rates were 33% and 77%, respectively (p<0.001). Median survival times were 8 and 20 months, respectively. Because most patients of group A died from extra-cerebral disease and/or new cerebral lesions, early systemic treatment and additional WBI should be considered. As cause of death in group B was mostly new cerebral metastases, additional WBI appears even more important for this group.