Abstract
Background
This study was performed to validate a scoring system published in 2008 to predict the survival of patients receiving whole-brain radiotherapy (WBRT) alone for brain metastases.
Methods
The scoring system included four independent prognostic factors: age, performance status, extracranial metastases, and interval between first diagnosis of cancer and WBRT. The score for each prognostic factor was determined by dividing the 6-month survival rate (in %) by 10. The total score represented the sum of the scores for each prognostic factor. Total scores ranged from 9–18 points, and patients were divided into four groups. In the present study, 350 new patients were evaluated in order to validate the previously developed score.
Results
In the present validation study, the 6-month survival rates were 8 % for patients with a score of 9–10 points (group A), 24 % for those with a score of 11–13 points (group B), 51 % for those with a score of 14–16 points (group C), and 82 % for those with scores of 17–18 points (group D), respectively (p < 0.001). In our previous study published in 2008, the 6-month survival rates were 6 %, 15 %, 43 %, and 76 %, respectively (p < 0.001). The comparisons between each of the four prognostic groups of both series did not reveal a significant difference.
Conclusion
In this study, the 6-month survival rates of the four prognostic groups were not significantly different from those of the preceding study. This demonstrates the validity and reproducibility of this score. The score can help select the appropriate treatment for the individual patient and help design prospective trials.
Zusammenfassung
Hintergrund
Ziel dieser Studie war die Validierung eines 2008 publizierten Scores zur Abschätzung der Überlebensprognose von Patienten mit Hirnmetastasen nach alleiniger Ganzhirnbestrahlung (WBRT).
Methoden
Der Score beinhaltete die vier unabhängigen Prognosefaktoren Alter, Allgemeinzustand, extrakranielle Metastasen zur Zeit der WBRT und Intervall von der Erstdiagnose der Tumorerkrankung bis zur WBRT. Der Score für jeden Prognosefaktor wurde ermittelt, indem die Überlebensrate nach 6 Monaten (in %) durch 10 dividiert wurde. Der Gesamtscore entsprach der Summe der vier Einzelscores und lag zwischen 9 und 18 Punkten. Entsprechend dem Gesamtscore wurden vier prognostische Gruppen gebildet. Um den initialen Score zu validieren, wurden 350 neue Patienten in die aktuelle Studie eingeschlossen.
Ergebnisse
In der aktuellen Serie betrugen die 6-Monats-Überlebensraten 8 % bei einem Score von 9–10 Punkten (Gruppe A), 24 % bei 11–13 Punkten (Gruppe B), 51 % bei 14–16 Punkten (Gruppe C) und 82 % bei 17–18 Punkten (Gruppe D; p < 0,001). In der Studie aus dem Jahr 2008 waren die 6-Monats-Überlebensraten jeweils 6 %, 15 %, 43 % und 76 % (p < 0,001). Die Vergleiche zwischen den einzelnen Prognosegruppen beider Serien ergaben keinen signifikanten Unterschied.
Schlussfolgerung
In der aktuellen Studie waren die 6-Monats-Überlebensraten der vier Prognosegruppen im Vergleich zur vorherigen Studie nicht signifikant unterschiedlich. Dies zeigt die Validität und Reproduzierbarkeit des Scores. Der Score kann bei der Wahl des geeigneten Therapieregimes für den individuellen Patienten hilfreich sein, ebenso bei der Entwicklung prospektiver Studien.
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Dziggel, L., Segedin, B., Podvrsnik, N. et al. Validation of a survival score for patients treated with whole-brain radiotherapy for brain metastases. Strahlenther Onkol 189, 364–366 (2013). https://doi.org/10.1007/s00066-013-0308-3
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DOI: https://doi.org/10.1007/s00066-013-0308-3