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Factores pronósticos en metástasis cerebrales: aplicación del análisis de particionamiento recursivo en la identificación de pacientes que se beneficiarían en términos de sobrevida con un tratamiento selectivo

Prognostic factors in brain metastases: application of recursive partitioning analysis to identify patients that would benefit in terms of survival with a selective treatment

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Resumen

En este estudio se aplica el análisis de particionamiento recursivo (APR) para identificar grupos de sobrevida diferentes.

Se analizaron sesenta y nueve pacientes con diagnóstico de metástasis cerebrales (MTSC) derivados para un tratamiento radiante paliativo (TRP). Inicialmente se evaluó la sobrevida univariada de las variables a 6 meses; luego se aplicó el modelo de Cox para identificar aquéllas independientes; el APR agrupó los pacientes considerando sus respectivas alternativas de respuesta.

Se identificaron tres grupos. El grupo I (n=47) (MTSC intra-SNC, <60 años, cualquier sede tumoral primaria, o≥60 años no primario pulmonar) mostró una sobrevida del 65,1% (50,8%–79,4%) (IC 95%). El grupo II (n=17) (MTSC intra-SNC, ≥ 60 años primarios pulmonares) mostró una tasa de supervivencia del 43,8% (19,5%–68,1%). El grupo III (n=5) (MTSC fuera-SNC cualquier edad y primario) murieron antes del cuarto mes de iniciado el TRP.

Este estudio sugirió que el APR permite identificar grupos de pacientes en quienes un tratamiento selectivo podría beneficiarlos en términos de sobrevida (grupo I y II) y síntomas (grupo III).

Abstract

Recursive partitioning analysis (RPA) was applied to identify prognostic different survival groups. Sixty nine patients with diagnostic of brain metastasis (BM) refered to palliative radiotherapy treatment (PRT) were analyzed. Initially, it was evaluated univariate 6-months survival prognostic factors; then Cox proportional hazard model was applied to identify those independent variables; the RPA grouped the patients considering their alternatives of response.

It was identified three groups. Group I (n=47) (BM in-CNS, <60 years any primary site, or ≥ 60 years other than lung primary tumor) showed 65.1% survival rate (50.8%–79.4%) (CI 95%). Group II (n=17) (BM in-CNS, ≥60 years with lung primary tumor) showed a survival rate of 43.8% (19.5%–68.1%). Group III (n=5) (BM out-CNS any primary site, any age) died before fourth month after PRT.

This study suggests that RPA allows to identify groups of patients which selective treatment would benefit them in terms of survival rate (group I and II) and symptoms (group III).

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Authors and Affiliations

  1. Terapia Radiante Cumbres, Necochea 1327, S2000BWC, Rosario, Argentina

    Susana Kahl Perpiñá (Especialista en Oncología Clínica y Radioterapia), José McDonnell Gutiérrez (Especialista en Física de la radioterapia) & Marta Alarcón Beketta (Estadística)

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  1. Susana Kahl Perpiñá
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  2. José McDonnell Gutiérrez
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  3. Marta Alarcón Beketta
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Correspondence to Susana Kahl Perpiñá.

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Perpiñá, S.K., Gutiérrez, J.M. & Beketta, M.A. Factores pronósticos en metástasis cerebrales: aplicación del análisis de particionamiento recursivo en la identificación de pacientes que se beneficiarían en términos de sobrevida con un tratamiento selectivo. Rev Oncol 4, 496–500 (2002). https://doi.org/10.1007/BF02712828

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