A new tool to predict survival after radiosurgery alone for newly diagnosed cerebral metastases

Asian Pac J Cancer Prev. 2015;16(7):2967-70. doi: 10.7314/apjcp.2015.16.7.2967.

Abstract

Many patients with few cerebral metastases receive radiosurgery alone. The goal of this study was to create a tool to estimate the survival of such patients. To identify characteristics associated with survival, nine variables including radiosurgery dose, age, gender, Eastern cooperative oncology group performance score (ECOG-PS), primary tumor type, number/size of cerebral metastases, location of cerebral metastases, extra-cerebral metastases and time between cancer diagnosis and radiosurgery were analyzed in 214 patients. On multivariate analysis, age (p=0.03), ECOG-PS (p=0.02) and extra-cerebral metastases (p<0.01) had significant impacts on survival. Scoring points for each patient were obtained from 12-month survival rates (in %) related to the significant variables divided by 10. Addition of the scoring points of the three variables resulted in a patient's total predictive score. Two groups were designed, A (10-14 points) and B (16-17 points). Twelve-month survival rates were 33% and 77%, respectively (p<0.001). Median survival times were 8 and 20 months, respectively. Because most patients of group A died from extra-cerebral disease and/or new cerebral lesions, early systemic treatment and additional WBI should be considered. As cause of death in group B was mostly new cerebral metastases, additional WBI appears even more important for this group.

MeSH terms

  • Brain Neoplasms / mortality*
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery
  • Cranial Irradiation / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Radiosurgery / methods
  • Retrospective Studies
  • Survival Rate