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- Title
A new updated prognostic index for patients with brain metastases (BMs) treated with palliative whole brain radiotherapy (WBRT) in the era of precision oncology. METASNCore project.
- Authors
Flores-Paco, Pablo; Vargas-Aliaga, Alicia; Guevara, María Geraldina; Lopera, Ignacio; Ruiz, Lucía Rodríguez; López-Herrero, María; Camús, Juan Adrián; López-González, Javier; Inga-Saavedra, Elizabeth; Montero, Marina; Barneto, Isidoro; Gómez-España, Mª Auxiliadora; Ruiz, Estela; Ruza, Marta; Armenta, Ana; Palacios, Amalia; De La Haba-Rodríguez, Juan R.; Aranda, Enrique
- Abstract
Introduction: Palliative WBRT is the main treatment for multiple BMs. Recent studies report no benefit in survival after WBRT compared to palliative supportive care in patients (pts) with poor prognosis. A new era of systemic treatment strategies based on targeted therapies are improving the prognosis of patients with BMs. The purpose of this study is to develop a prognostic score in palliative pts with BMs who undergo WBRT in this new setting. Methods: 239 pts with BMs who received palliative WBRT between 2013–2022 in our center were analyzed retrospectively. The score was designed according to the value of the β coefficient of each variable with statistical significance in the multivariate model using Cox regression. Once the score was established, a comparison was performed according to Kaplan–Meier and was analyzed by log-rank test. Results: 149 pts (62.3%) were male and median (m) age was 60 years. 139 (58,2%) were lung cancer and 35 (14,6%) breast cancer. All patients received 30Gys in 10 sessions. m overall survival (OS) was 3,74 months (ms). 37 pts (15,5%) had a specific target mutation. We found that 62 pts were in group < 4 points with mOS 6,89 ms (CI 95% 3,18–10,62), 84 in group 4–7 points with mOS 4,01 ms (CI 95% 3,40–4,62) and 92 pts in group > 7 points with mOS 2,72 ms (CI 95% 1,93–3,52) (p < 0,001). Conclusions: METASNCore items are associated with OS and they could be useful to select palliative pts to receive WBRT. More studies are necessary to corroborate our findings.
- Subjects
OVERALL survival; PALLIATIVE medicine; RADIOTHERAPY; LOG-rank test; POINT set theory
- Publication
Journal of Neuro-Oncology, 2024, Vol 167, Issue 3, p407
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-024-04618-1