Whole brain radiotherapy for poor prognosis patients with brain metastases: predictably poor results.

The journal of supportive oncology Pub Date : 2013-12-01 DOI:10.12788/j.suponc.0006

Neil C Estabrook, Stephen T Lutz, Cynthia S Johnson, Mark A Henderson

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引用次数: 4

Abstract

Background: Patients with brain metastases from solid tumors can be subdivided by characteristics into separate prognostic groups, such as the Radiation Therapy Oncology Group's Recursive Partitioning Analysis (RPA) or the Graded Prognostic Assessment (GPA). At our institution, patients falling into the poorest prognostic groups are often treated with whole brain radiotherapy (WBRT).

Objective: To determine if observed survival of poor prognosis patients treated with WBRT for brain metastases at our institution matches the survival predicted by RPA and GPA prognostic indices.

Methods: The charts of 101 consecutive patients with newly diagnosed brain metastases from solid tumors who received WBRT were retrospectively reviewed. We calculated each patient's RPA and GPA and compiled treatment and survival data. Observed median survival was compared to that predicted by the RPA and GPA prognostic indices.

Results: RPA III patients (n = 25) had a median survival of 2.4 months in our study. GPA 0.0-1.0 patients (n = 35) had a median survival of 2.4 months in our study. These values did not vary significantly from those predicted by the respective indices.

Limitations: This is a retrospective analysis and subject to selection bias.

Conclusion: Given the delivery time for WBRT and the potential side effects associated with the treatment, the predictably short overall survival in poor prognosis patients calls into question the value of WBRT in this patient subgroup.

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预后不良脑转移患者的全脑放疗:可预见的不良结果。

背景:实体瘤脑转移患者可以根据特征细分为单独的预后组，如放射治疗肿瘤学组的递归划分分析(RPA)或分级预后评估(GPA)。在我们的机构，属于预后最差群体的患者经常接受全脑放疗(WBRT)。目的:确定在我院接受WBRT治疗的脑转移不良预后患者的观察生存是否与RPA和GPA预后指标预测的生存相匹配。方法:回顾性分析101例新诊断的实体瘤脑转移患者行WBRT治疗的临床资料。我们计算每位患者的RPA和GPA，并汇编治疗和生存数据。将观察到的中位生存期与RPA和GPA预后指标预测的中位生存期进行比较。结果:在我们的研究中，RPA III型患者(n = 25)的中位生存期为2.4个月。在我们的研究中，GPA为0.0-1.0的患者(n = 35)的中位生存期为2.4个月。这些值与各自指数的预测值没有显著差异。局限性:这是一项回顾性分析，可能存在选择偏差。结论:考虑到WBRT的给药时间和与治疗相关的潜在副作用，在预后不良的患者中可预见的较短的总生存期使WBRT在该患者亚组中的价值受到质疑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The journal of supportive oncology

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