Prognostic models for patients with brain metastases after stereotactic radiosurgery with or without whole brain radiotherapy: a validation study

Rice, Stephanie R.; Bentzen, Søren M.; Hanna, Andrew; Choi, E.; Boggs, Drexell Hunter; Kwok, Young; Hyder, J.; Feigenberg, Steven J.; Regine, William F.; Woodworth, Graeme F.; Eisenberg, Howard M.; Yu, C; Biggins, Terri F.; Barnholtz‐Sloan, Jill S.; Sperduto, Paul W.; Weltman, Eduardo; Mehta, Minesh P.

doi:10.1007/s11060-018-2958-6

Cited by 14 publications

(7 citation statements)

References 25 publications

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“…In addition, we found that the PIs in our study were not uniformly recommended in different studies, and there was a large discrepancy between the expected and actual survival[18, [40][41][42]. This nding supports the need for a better prognostic tool or index.…”

Section: Discussionmentioning

confidence: 59%

Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases

Xie

Peng

Zhang

et al. 2022

Preprint

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Background and purpose To evaluate the clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) combined with whole brain radiotherapy (WBRT) in patients with brain metastases (BMs). Materials and methods From May 2018 to July 2020, 50 patients (111 lesions) received HFSRT (18Gy/3F) + WBRT (40Gy/20F). The RECIST 1.1 and RANO-BM criteria were used to evaluate treatment efficacy. Five prognostic indexes (RPA, GPA, SIR, BS-BM, and GGS) were applied. The primary endpoint was intracranial local control (iLC). Secondary endpoints were overall survival (OS) and the safety of treatment. Results Intracranial objective response rates (iORR) using the RECIST 1.1 and RANO-BM criteria were 62.1% and 58.6%, respectively. The iLC rate was 93.1%, the 6- and 12-month iLC rates were 90.8% and 57.4%, respectively. The median intracranial progression-free survival (iPFS) was not reached (range 0 − 23 months). The 6-, 12-, and 24-month OS rates were 74.2%, 58.2%, and 22.9%, respectively. The KPS score showed statistical significance in univariate analysis of survival. The 6, 12, and 24 month OS rates for patients with KPS ≥ 70 were 83.8%, 70.5%, and 29.7%, respectively. The median survival time (MST) for all patients and for patients with KPS ≥ 70 were 13.6 and 16.5 months, respectively. Sex, KPS score, and gross tumor volume were significant factors in the multivariate analysis of survival. OS was significantly associated with RPA, SIR, BS-BM, and GGS classes. No acute toxicities of grade 3 or higher were noted. Conclusion HFSRT combined with WBRT is a safe and effective local treatment modality for BM patients.

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Section: Discussionmentioning

confidence: 59%

Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases

Xie

Peng

Zhang

et al. 2022

Preprint

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“…In the only study to date that validated the molGPA score, 70% of patients received WBRT and concurrent systemic therapy was likewise not recorded [18]. Other available scores have been shown to underestimate OS as these were all developed before widespread implementation of TT/IT [19]. Two studies have aimed to validate prognostic scores in TT/IT-treated patient cohorts that received concomitant SRT to date, albeit omitting the most widely used molGPA score [20,21].…”

Section: Introductionmentioning

confidence: 99%

Predicting survival in melanoma patients treated with concurrent targeted- or immunotherapy and stereotactic radiotherapy

et al. 2020

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Background: Melanoma patients frequently develop brain metastases. The most widely used score to predict survival is the molGPA based on a mixed treatment of stereotactic radiotherapy (SRT) and whole brain radiotherapy (WBRT). In addition, systemic therapy was not considered. We therefore aimed to evaluate the performance of the molGPA score in patients homogeneously treated with SRT and concurrent targeted therapy or immunotherapy (TT/IT). Methods: This retrospective analysis is based on an international multicenter database (TOaSTT) of melanoma patients treated with TT/IT and concurrent (≤30 days) SRT for brain metastases between May 2011 and May 2018. Overall survival (OS) was studied using Kaplan-Meier survival curves and log-rank testing. Uni-and multivariate analysis was performed to analyze prognostic factors for OS. Results: One hundred ten patients were analyzed. 61, 31 and 8% were treated with IT, TT and with a simultaneous combination, respectively. A median of two brain metastases were treated per patient. After a median follow-up of 8 months, median OS was 8.4 months (0-40 months). The molGPA score was not associated with OS. Instead, cumulative brain metastases volume, timing of metastases (syn-vs. metachronous) and systemic therapy with concurrent IT vs. TT influenced OS significantly. Based on these parameters, the VTS score (volume-timing-systemic therapy) was established that stratified patients into three groups with a median OS of 5.1, 18.9 and 34.5 months, respectively (p = 0.001 and 0.03).

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“…Ideally, patients with limited prognosis would not be exposed to the unnecessary burden of intense treatment, whereas those with better prognosis would receive the therapeutic measures required to prevent neurologic death [11,12]. Several tools (prognostic scores and nomograms with survival and other endpoints) have been developed to support decision-making [13][14][15][16][17]. Initially, they were heavily based on performance status and extracranial disease extent or control, and not stratified by primary cancer type.…”

Section: Introductionmentioning

confidence: 99%

LabBM Score and Extracranial Score As New Tools for Predicting Survival in Patients with Brain Metastases Treated with Focal Radiotherapy

Nieder¹,

Yobuta²,

Mannsåker³

2020

Cureus

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Prognostic models for patients with brain metastases after stereotactic radiosurgery with or without whole brain radiotherapy: a validation study

Cited by 14 publications

References 25 publications

Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases

Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases

Predicting survival in melanoma patients treated with concurrent targeted- or immunotherapy and stereotactic radiotherapy

LabBM Score and Extracranial Score As New Tools for Predicting Survival in Patients with Brain Metastases Treated with Focal Radiotherapy

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