Purpose: Graded Prognostic Assessment (GPA) is a new prognostic index for patients with brain metastases. Brain metastasis is a common site of metastasis in lung cancers. Lung cancer-specific GPA scoring system is used. We aimed to assess the prognostic and predictive significance of Graded Prognostic Assessment (GPA) score in non small-cell lung cancer patients with brain metastasis.
Materials and Methods: This study was designed as a hospital-based retrospective observational case-series study. A total of 95 patients with brain metastatic NSCLC patients who were followed in two different oncology centers in Turkey between 2015 and 2021 have been included into this study. They were divided into 3 groups according to their GPA scores.
Results: The median age of the patients was 62 (range 44-89) years The patients were divided into 3 groups according to their GPA scores. 24 (25.2 %) patients had ‘’0-1’’ GPA score, 54 (56,8 %) patients had ‘’1,5-2’’ GPA score and 17 (18 %) patients had ‘’2,5-3’’ GPA score. The median follow-up time was 11 months and 89 (93.7%) patients died during follow-up. Overall survival (OS) was 8 months. Patients in the low (0-1) GPA scores had worst overall survival than those with higher GPA scores (4.7, 12.6 and 18.5 months respectively and p=0,001).
Conclusion: In this study, we have shown that GPA score is useful in evaluating the prognosis of NSCLC patients with brain metastasis
Background: We aimed to investigate the efficacy and tolerability of ultra-hypofractionated radiotherapy (UHRT) in the treatment of low and intermediate-risk prostate cancer patients. Methods: This retrospective study was conducted using data derived from 44 patients who underwent UHRT, and toxicity assessment and clinical response were investigated. Treatment consisted of 35-36.25 Gy in 5 fractions using stereotactic ablative radiotherapy (SABR) with the Linac-based delivery system. Results: The median duration of follow-up was 52 months (8-68 months) and the median age was 71.5 years (54-85 years). Twenty-seven patients were assigned as intermediate-risk, whereas 17 patients had low-risk. The 5-year overall survival rate was 87.8%, while the 5-year biochemical recurrence-free survival (bRFS) rate was 97.4%. Acute grade 3 genitourinary (GU) side effect was not observed in any patient, whereas acute gastrointestinal (GI) system grade 3 side effect was seen in 6.8% of the patients. Late grade 3 GU and GI side effects were seen in 4.6% and 6.8% of the patients, respectively. In patients with planning target volume (PTV) !85 ml, acute grade !2 GU side effects were more common (p¼.034). Conclusion: Our data demonstrated that UHRT administered with volumetric arc therapy (VMAT) can be recommended for selected patients with low-intermediate risk prostate cancer. Further prospective, multicentric, controlled trials on larger series are warranted to reach more accurate conclusions.
Aim
To extend the survival of patients by providing local control of metastases in oligoresistance/oligoprogressive disease.
Methods
We retrospectively evaluated the efficacy of stereotactic body radiotherapy (SBRT) applied to 30 lesions in the lungs of 19 patients who were considered inoperable by the tumor board upon the development of oligoresistance/oligoprogressive lung metastasis while undergoing chemotherapy between January 2016 and December 2017. Each patient had one to five metastases in their lungs. The median SBRT biologic effective dose at α/β of 10 (BED
10
) was 180.0 (IQR: 115.5–180.0) Gy.
Results
We obtained effective, low-toxicity results. The rates of local control were 89.4%, 84.2%, and 78.9% for the 1st, 2nd, and 3rd years, respectively. The median local control time was 4 (IQR: 3–6) months. The median overall survival (OS) was 36.3 (IQR: 29.7–42.9) months. The rates of OS for the 1st, 2nd, and 3rd years were 89.5%, 73.7%, and 61.4%, respectively. Despite the nonoccurrence of grade 4–5 toxicity in the lungs, six (31.6%) patients had grade 1–3 pulmonary pneumonia, one patient had a grade 4 skin ulceration, and two patients had increased chronic obstructive pulmonary disease in the follow-up period.
Discussion
In patients with oligometastatic lung tumors, SBRT is very effective in terms of progression-free survival and OS.
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