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- Title
Applicability and limitations of a recently-proposed prognostic grading metric, initial brain metastasis velocity, for brain metastasis patients undergoing stereotactic radiosurgery.
- Authors
Yamamoto, Masaaki; Aiyama, Hitoshi; Koiso, Takao; Watanabe, Shinya; Kawabe, Takuya; Sato, Yasunori; Higuchi, Yoshinori; Kasuya, Hidetoshi; Barfod, Bierta E.
- Abstract
Purpose: This study, based on our brain metastasis (BM) patients undergoing stereotactic radiosurgery (SRS) procedures, aimed to validate whether the recently-proposed prognostic grading system, initial brain metastasis velocity (iBMV, scoring the cumulative number of BMs at the time of SRS divided by time [years] since the initial primary cancer diagnosis), is generally applicable. Methods: This was an institutional review board-approved, retrospective cohort study using our prospectively accumulated database including 3498 patients who underwent SRS for BMs during the 19.5-year-period between July, 1998 and December, 2017. We excluded four lost to follow-up, 24 for whom the day of primary cancer diagnosis was not available, 665 with synchronous presentation and 651 with pre-SRS radiotherapy and/or surgery, ultimately studying 2150 patients. Patients were categorized into two classes by iBMV scores, i.e., < 2.00 and ≥ 2.00. Results: In a multivariable model, iBMV was directly associated with a higher risk of death (p < 0.0001). The median survival time of patients with iBMV scores < 2.00, 10.0 (95% CI; 9.2–10.9) months, was longer than that of patients with iBMV scores ≥ 2.00, 6.3 (5.6–6.7) months, showing a significant difference between the two groups (HR 1.599, 95% CI 1.458–1.753, p < 0.0001). The same results were obtained in patients with non-small cell lung, breast, kidney or other cancers. Among 608 patients who underwent repeat SRS for newly-developed BMs, iBMV score categories correlated well with brain metastasis velocity risk groups (p < 0.0001). Conclusions: Our present results support the validity of iBMV for predicting survival after SRS.
- Subjects
STEREOTACTIC radiosurgery; BRAIN metastasis; VELOCITY; RENAL cancer; GROUP velocity; CANCER diagnosis
- Publication
Journal of Neuro-Oncology, 2019, Vol 143, Issue 3, p613
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-019-03199-8