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- Title
A new grading system focusing on functional preservation for brain metastasis patients treated with gamma knife surgery.
- Authors
T. Serizawa; Y. Higuchi; O. Agano; S. Matsuda; J. Ono; N. Saeki; T. Hirai; A. Miyakawa; Y. Shibamoto
- Abstract
Purpose: Functional preservation (qualitative survival, QS) has been regarded as one of the ideal endpoints for evaluating treatment results for patients with brain metastases. However, previous reports on grading systems for brain metastasis patients, i.e. RPA, SIR, BSBM and GPA, are based on only overall survival (OS), not QS. Herein, we propose a new grading system for predicting both OS and QS in patients undergoing gamma knife radiosurgery (GKS). Methods: Among 2481 brain metastasis cases, treated with GKS, we verified common poor prognostic factors for OS and QS. Results: There were 1490 men and 991 women. Median age was 65, range 7-94. The most common primary site was the lung (1629 cases), followed by gastro-intestine (315), breast (268), uro-genital (147) and others (122). Median survival times (MSTs) were 7.7 months for OS and 46.4 months for QS. The common significant prognostic factors were initial KPS score (poor factor; <70, p<0.0001), maximum tumor diameter (>25mm, p<0.0001), brain lesion number (multiple, p=0.0002), and extra-cranial disease status (active, p=0.0044). According to the sum of these 4 risk factors, we classify the "low" risk group (547 cases) as having a score of 0 or 1; "intermediate" a score of 2 (1176); and "high" (758) a score of 3 or 4. MSTs for QS were 71.9 months in the "low", 42.3 in the "intermediate" and 19.0 in the "high" risk group. There were highly significant differences among the adjacent groups (p<0.0001, 0.0002). MSTs for OS were 15.5 months in the "low", 7.8 in the "intermediate" and 4.9 in the "high" risk group. Differences among groups were also significant (p<0.0001). Conclusions: Our new index, the QS score (QSS), was found to be excellent for predicting both OS and QS simultaneously in brain metastasis patients undergoing GKS. Disclosure: No significant relationships.
- Subjects
BRAIN metastasis; CANCER patients; RADIOSURGERY; CANCER prognosis; CANCER invasiveness
- Publication
Journal of Radiosurgery & SBRT, 2013, Vol 2, p5
- ISSN
2156-4639
- Publication type
Article