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

  • Rades, Dirk (Department of Radiation Oncology, Faculty of Medicine, University of Lubeck) ;
  • Huttenlocher, Stefan (Department of Radiation Oncology, Faculty of Medicine, University of Lubeck) ;
  • Dziggel, Liesa (Department of Radiation Oncology, Faculty of Medicine, University of Lubeck) ;
  • Blanck, Oliver (Department of Radiosurgery, CyberKnife Centre Northern Germany) ;
  • Hornung, Dagmar (Department of Radiation Oncology, Faculty of Medicine, University of Hamburg) ;
  • Mai, Khoa Trong (Department of Nuclear Medicine, Faculty of Medicine Hanoi Medical University) ;
  • Ngo, Trang Thuy (Department of Radiation Oncology, Nuclear Medicine and Oncology Center, Bach Mai Hospital) ;
  • Pham, Thai Van (Department of Radiation Oncology, Nuclear Medicine and Oncology Center, Bach Mai Hospital) ;
  • Schild, Steven (Department of Radiation Oncology, Mayo Clinic Scottsdale)
  • Published : 2015.04.14

Abstract

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.

Keywords

Cerebral metastases;radiosurgery alone;survival;prognostic factors;predictive tool

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