分级预后评估(GPA)量表的发展和适应:一项系统综述。

IF 4.2 3区 医学 Q2 ONCOLOGY
Clinical & Experimental Metastasis Pub Date : 2023-12-01 Epub Date: 2023-10-11 DOI:10.1007/s10585-023-10237-3
Luana Marques Ribeiro, Fernanda Ferreira Bomtempo, Rebeka Bustamante Rocha, João Paulo Mota Telles, Eliseu Becco Neto, Eberval Gadelha Figueiredo
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引用次数: 0

摘要

分级预后评估(GPA)评分在脑转移瘤(BM)患者的预后量表中具有最佳的准确性。针对不同类型的原发性肿瘤BM,已经建立了广泛的GPA衍生量表。然而,它们之间存在高度的可变性,并且它们的特征尚未完全描述。我们的目的是总结现有GPA衍生量表的特点,并比较它们的预测因素及其在临床环境中的应用。Medline从成立到2023年1月进行了搜索,以确定与GPA的开发、更新或验证相关的研究。最初的搜索得到了1083个结果。包括16项原始研究和16项验证研究,共包括33348名患者。评估了13种不同的量表,包括:GPA、诊断特异性GPA、颅外评分、Lung-molGPA、更新的肾脏GPA、升级的胃肠道GPA、修改的乳房GPA、整合的黑色素瘤GPA、黑色素瘤Mol GPA、肉瘤GPA、肝癌GPA、结直肠癌癌症GPA和癌症GPA。最常见的预后预测因素是年龄、Karnofsky表现状态、BM数量以及是否存在颅外转移。治疗方式包括全脑放射治疗、立体定向放射外科、手术、颅骨放射治疗、伽玛刀放射外科和BRAF抑制剂治疗。未接受治疗和接受特定治疗的中位生存率分别为6.1周到33个月和3.1到21个月。原始GPA和GPA衍生量表是有效的预后工具,但相互比较时存在异质性生存结果。需要更多的研究来改进这些量表的科学证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Development and adaptations of the Graded Prognostic Assessment (GPA) scale: a systematic review.

Development and adaptations of the Graded Prognostic Assessment (GPA) scale: a systematic review.

The Graded Prognostic Assessment (GPA) score has the best accuracy among prognostic scales for patients with brain metastases (BM). A wide range of GPA-derived scales have been established to different types of primary tumor BM. However, there is a high variability between them, and their characteristics have not been described altogether yet. We aim to summarize the features of the existent GPA-derived scales and to compare their predictor factors and their uses in clinical setting. Medline was searched from inception until January 2023 to identify studies related to the development, update, or validation of GPA. The initial search yielded 1,083 results. 16 original studies and 16 validation studies were included, comprising a total of 33,348 patients. 13 different scales were assessed, including: GPA, Diagnosis-Specific GPA, Extracranial Score, Lung-molGPA, Updated Renal GPA, Updated Gastrointestinal GPA, Modified Breast GPA, Integrated Melanoma GPA, Melanoma Mol GPA, Sarcoma GPA, Hepatocellular Carcinoma GPA, Colorectal Cancer GPA, and Uterine Cancer GPA. The most prevalent prognostic predictors were age, Karnofsky Performance Status, number of BM, and presence or absence of extracranial metastases. Treatment modalities consisted of whole brain radiation therapy, stereotactic radiosurgery, surgery, cranial radiotherapy, gamma knife radiosurgery, and BRAF inhibitor therapy. Median survival rates with no treatment and with a specific treatment ranged from 6.1 weeks to 33 months and from 3.1 to 21 months, respectively. Original GPA and GPA-derived scales are valid prognostic tools, but with heterogeneous survival results when compared to each other. More studies are needed to improve scientific evidence of these scales.

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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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