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Title: Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis

Abstract

Purpose: To assess the utility of the Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and Score Index for Radiosurgery (SIR) stratification systems in predicting survival in patients with brain metastasis treated with Gamma Knife radiosurgery (GKRS). Methods and Materials: A total of 185 patients were included in the study. Patients were stratified according to RPA and SIR classes. The RPA and SIR classes, age, Karnofsky Performance Status (KPS), and systemic disease were correlated with survival. Results: Five patients were lost to follow-up. Median survival in patients in RPA Class 1 (30 patients) was 17 months; in Class 2 (140 patients), 10 months; and in Class 3 (10 patients), 3 months. Median survival in patients in SIR Class 1 (30 patients) was 3 months; in Class 2 (135 patients), 8 months; and in Class 3 (15 patients), 20 months. In univariate testing, age younger than 65 years (p = 0.0004), KPS higher than 70 (p = 0.0001), RPA class (p = 0.0078), SIR class (p = 0.0002), and control of the primary tumor (p = 0.02) were significantly associated with improved outcome. In multivariate analysis, KPS (p < 0.0001), SIR class (p = 0.0008), and RPA class (p = 0.03)more » had statistical value. Conclusions: This study supports the use of GKRS as a single-treatment modality in this selected group of patients. Stratification systems are useful in the estimation of patient eligibility for GKRS. A second-line treatment was necessary in 30% of patients to achieve distal or local brain control. This strategy is useful to control brain metastasis in long-surviving patients.« less

Authors:
 [1]; ;  [2];  [3]; ; ; ;  [2]
  1. Department of Neurosurgery and Radiosurgery, University Vita-Salute, IRCCS San Raffaele, Milan (Italy), E-mail: franzin.alberto@hsr.it
  2. Department of Neurosurgery and Radiosurgery, University Vita-Salute, IRCCS San Raffaele, Milan (Italy)
  3. Department of Radiation Oncology, University Vita-Salute, IRCCS San Raffaele, Milan (Italy)
Publication Date:
OSTI Identifier:
21276854
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 74; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2008.08.062; PII: S0360-3016(08)03489-5; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; METASTASES; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; PERFORMANCE; RADIOTHERAPY; SURGERY

Citation Formats

Franzin, Alberto, Snider, Silvia, Picozzi, Piero, Bolognesi, Angelo, Serra, Carlo, Vimercati, Alberto, Passarin, Olga, and Mortini, Pietro. Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.08.062.
Franzin, Alberto, Snider, Silvia, Picozzi, Piero, Bolognesi, Angelo, Serra, Carlo, Vimercati, Alberto, Passarin, Olga, & Mortini, Pietro. Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis. United States. doi:10.1016/j.ijrobp.2008.08.062.
Franzin, Alberto, Snider, Silvia, Picozzi, Piero, Bolognesi, Angelo, Serra, Carlo, Vimercati, Alberto, Passarin, Olga, and Mortini, Pietro. Wed . "Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis". United States. doi:10.1016/j.ijrobp.2008.08.062.
@article{osti_21276854,
title = {Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis},
author = {Franzin, Alberto and Snider, Silvia and Picozzi, Piero and Bolognesi, Angelo and Serra, Carlo and Vimercati, Alberto and Passarin, Olga and Mortini, Pietro},
abstractNote = {Purpose: To assess the utility of the Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and Score Index for Radiosurgery (SIR) stratification systems in predicting survival in patients with brain metastasis treated with Gamma Knife radiosurgery (GKRS). Methods and Materials: A total of 185 patients were included in the study. Patients were stratified according to RPA and SIR classes. The RPA and SIR classes, age, Karnofsky Performance Status (KPS), and systemic disease were correlated with survival. Results: Five patients were lost to follow-up. Median survival in patients in RPA Class 1 (30 patients) was 17 months; in Class 2 (140 patients), 10 months; and in Class 3 (10 patients), 3 months. Median survival in patients in SIR Class 1 (30 patients) was 3 months; in Class 2 (135 patients), 8 months; and in Class 3 (15 patients), 20 months. In univariate testing, age younger than 65 years (p = 0.0004), KPS higher than 70 (p = 0.0001), RPA class (p = 0.0078), SIR class (p = 0.0002), and control of the primary tumor (p = 0.02) were significantly associated with improved outcome. In multivariate analysis, KPS (p < 0.0001), SIR class (p = 0.0008), and RPA class (p = 0.03) had statistical value. Conclusions: This study supports the use of GKRS as a single-treatment modality in this selected group of patients. Stratification systems are useful in the estimation of patient eligibility for GKRS. A second-line treatment was necessary in 30% of patients to achieve distal or local brain control. This strategy is useful to control brain metastasis in long-surviving patients.},
doi = {10.1016/j.ijrobp.2008.08.062},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 74,
place = {United States},
year = {2009},
month = {7}
}