Generation of a New Disease-specific Prognostic Score for Patients With Brain Metastases From Small-cell Lung Cancer Treated With Whole Brain Radiotherapy (BMS-Score) and Validation of Two Other Indices |
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| Authors: | Denise Bernhardt Laila König Sophie Aufderstrasse Johannes Krisam Juliane Hoerner-Rieber Sebastian Adeberg Farastuk Bozorgmehr Rami El Shafie Kristin Lang Jutta Kappes Michael Thomas Felix Herth Claus Peter Heußel Arne Warth Samuel Marcrom Jürgen Debus Martin Steins Stefan Rieken |
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| Affiliation: | 1. University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany;2. Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany;3. Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany;4. Department of Pneumology, Thoraxklinik, Heidelberg University, Heidelberg, Germany;5. Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany;6. Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany;7. Member of the German Centre for Lung Research (DZL), Heidelberg, Germany;8. Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany;9. Diagnostic and Interventional Radiology at University of Heidelberg, Heidelberg, Germany;10. Institute of Pathology, Heidelberg University, Heidelberg, Germany;11. Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL;12. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany |
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| Abstract: | IntroductionPatients with small-cell lung cancer (SCLC) demonstrate an exception in the treatment of brain metastases (BM), because in patients with SCLC whole brain radiotherapy (WBRT) only is the preferred treatment modality. The purpose of this study was to develop a prognostic score for patients with brain metastases from SCLC treated with WBRT.Patients and MethodsThe present study was conducted utilizing a single-institution, previously described, retrospective database of patients with SCLC who were treated with WBRT (n = 221). Univariate and multivariate analyses were performed to generate the “brain metastases from SCLC score” (BMS score) based on favorable prognostic factors: Karnofsky performance status (KPS > 70), extracerebral disease status (stable disease/controlled), and time of appearance of BM (synchronous). Furthermore, the disease-specific graded prognostic assessment score as well as the recursive partitioning analysis (RPA) were performed and compared with the new BMS score by using the log-rank (Mantel-Cox) test.ResultsBMS score and RPA showed the most significant differences between classes (P < .001). BMS score revealed a mean overall survival (OS) of 2.62 months in group I (0-1 points), 6.61 months in group II (2-3 points), and 12.31 months in group III (4 points). The BMS score also identified the group with the shortest survival (2.62 months in group I), and the numbers of patients in each group were most equally distributed with the BMS score.ConclusionThe new BMS score was more prognostic than the RPA and disease-specific graded prognostic assessment scores. The BMS score is easy to use and reflects known prognostic factors in contemporary patients with SCLC treated with WBRT. Future studies are necessary to validate these findings. |
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| Keywords: | Cranial irradiation Extensive disease SCLC Survival WBRT |
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