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Title: Outcome After Radiosurgery for Brain Metastases in Patients With Low Karnofsky Performance Scale (KPS) Scores

Abstract

Purpose: The objective of this retrospective study was evaluation of the outcome after stereotactic radiosurgery (SRS) in patients with intracranial metastases and poor performance status. Methods and Materials: Forty consecutive patients with metastatic brain tumors and Karnofsky performance scale (KPS) scores {<=}50 (mean, 43 {+-} 8; median, 40) treated with SRS were analyzed. Poor performance status was caused by presence of intracranial metastases in 28 cases (70%) and resulted from uncontrolled extracerebral disease in 12 (30%). Results: Survival after SRS varied from 3 days to 11.5 months (mean, 3.8 {+-} 2.9 months; median, 3.3 months). Survival probability constituted 0.50 {+-} 0.07 at 3 months and 0.20 {+-} 0.05 at 6 months posttreatment. Cause of low KPS score (p = 0.0173) and presence of distant metastases beside the brain (p = 0.0308) showed statistically significant associations with overall survival in multivariate Cox proportional hazards regression analysis. Median survival was 6.0 months if low KPS score was caused by cerebral disease and distant metastases in regions beyond the brain were absent, 3.3 months if low KPS score was caused by cerebral disease and distant metastases in regions beyond the brain were present, and 1.0 month if poor performance status resulted from extracerebralmore » disease. Conclusions: Identification of the cause of low KPS score (cerebral vs. extracerebral) in patients with metastatic brain tumor(s) may be important for prediction of the outcome after radiosurgical treatment. If poor patient performance status without surgical indications is caused by intracranial tumor(s), SRS may be a reasonable treatment option.« less

Authors:
 [1];  [2]; ; ; ;  [2];  [3];  [3];  [4];  [4]
  1. Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo (Japan)|[International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, Tokyo (Japan). E-mail: m_chernov@yahoo.com
  2. Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo (Japan)
  3. Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo (Japan)|[Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo (Japan)
  4. Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo (Japan)|[Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo (Japan)|[International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, Tokyo (Japan)
Publication Date:
OSTI Identifier:
20951596
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.11.023; PII: S0360-3016(06)03524-3; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; CARCINOMAS; METASTASES; MULTIVARIATE ANALYSIS; PATIENTS; PERFORMANCE; RADIOTHERAPY; REGRESSION ANALYSIS; SURGERY

Citation Formats

Chernov, Mikhail F., Nakaya, Kotaro, Izawa, Masahiro, Usuba, Yuki, Kato, Koichi, Hori, Tomokatsu, Hayashi, Motohiro, Muragaki, Yoshihiro, Iseki, Hiroshi, and Takakura, Kintomo. Outcome After Radiosurgery for Brain Metastases in Patients With Low Karnofsky Performance Scale (KPS) Scores. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.11.023.
Chernov, Mikhail F., Nakaya, Kotaro, Izawa, Masahiro, Usuba, Yuki, Kato, Koichi, Hori, Tomokatsu, Hayashi, Motohiro, Muragaki, Yoshihiro, Iseki, Hiroshi, & Takakura, Kintomo. Outcome After Radiosurgery for Brain Metastases in Patients With Low Karnofsky Performance Scale (KPS) Scores. United States. doi:10.1016/j.ijrobp.2006.11.023.
Chernov, Mikhail F., Nakaya, Kotaro, Izawa, Masahiro, Usuba, Yuki, Kato, Koichi, Hori, Tomokatsu, Hayashi, Motohiro, Muragaki, Yoshihiro, Iseki, Hiroshi, and Takakura, Kintomo. Sun . "Outcome After Radiosurgery for Brain Metastases in Patients With Low Karnofsky Performance Scale (KPS) Scores". United States. doi:10.1016/j.ijrobp.2006.11.023.
@article{osti_20951596,
title = {Outcome After Radiosurgery for Brain Metastases in Patients With Low Karnofsky Performance Scale (KPS) Scores},
author = {Chernov, Mikhail F. and Nakaya, Kotaro and Izawa, Masahiro and Usuba, Yuki and Kato, Koichi and Hori, Tomokatsu and Hayashi, Motohiro and Muragaki, Yoshihiro and Iseki, Hiroshi and Takakura, Kintomo},
abstractNote = {Purpose: The objective of this retrospective study was evaluation of the outcome after stereotactic radiosurgery (SRS) in patients with intracranial metastases and poor performance status. Methods and Materials: Forty consecutive patients with metastatic brain tumors and Karnofsky performance scale (KPS) scores {<=}50 (mean, 43 {+-} 8; median, 40) treated with SRS were analyzed. Poor performance status was caused by presence of intracranial metastases in 28 cases (70%) and resulted from uncontrolled extracerebral disease in 12 (30%). Results: Survival after SRS varied from 3 days to 11.5 months (mean, 3.8 {+-} 2.9 months; median, 3.3 months). Survival probability constituted 0.50 {+-} 0.07 at 3 months and 0.20 {+-} 0.05 at 6 months posttreatment. Cause of low KPS score (p = 0.0173) and presence of distant metastases beside the brain (p = 0.0308) showed statistically significant associations with overall survival in multivariate Cox proportional hazards regression analysis. Median survival was 6.0 months if low KPS score was caused by cerebral disease and distant metastases in regions beyond the brain were absent, 3.3 months if low KPS score was caused by cerebral disease and distant metastases in regions beyond the brain were present, and 1.0 month if poor performance status resulted from extracerebral disease. Conclusions: Identification of the cause of low KPS score (cerebral vs. extracerebral) in patients with metastatic brain tumor(s) may be important for prediction of the outcome after radiosurgical treatment. If poor patient performance status without surgical indications is caused by intracranial tumor(s), SRS may be a reasonable treatment option.},
doi = {10.1016/j.ijrobp.2006.11.023},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 67,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2007},
month = {Sun Apr 01 00:00:00 EDT 2007}
}