Validation of the new graded prognostic assessment scale for brain metastases: a multicenter prospective study
Author
Villà, Salvador
Weber, Damien C.
Moretones, Cristina
Mañes, Anabel
Combescure, Christophe
Jové, Josep
Puyalto, Paloma
Cuadras, Patricia
Bruna, Jordi
Verger, Eugènia
Balañà, Carme
Graus, Francesc
Publication date
2011ISSN
1748-717X
Abstract
Background: Prognostic indexes are useful to guide tailored treatment strategies for cancer patients with brain metastasis (BM). We evaluated the new Graded Prognostic Assessment (GPA) scale in a prospective validation study to compare it with two published prognostic indexes. Methods: A total of 285 newly diagnosed BM (n = 85 with synchronous BM) patients, accrued prospectively between 2000 and 2009, were included in this analysis. Mean age was 62 ± 12.0 years. The median KPS and number of BM was 70 (range, 20-100) and 3 (range, 1-50), respectively. The majority of primary tumours were lung (53%), or breast (17%) cancers. Treatment was administered to 255 (89.5%) patients. Only a minority of patients could be classified prospectively in a favourable prognostic class: GPA 3.5-4: 3.9%; recursive partitioning analysis (RPA) 1, 8.4% and Basic Score for BM (BSBM) 3, 9.1%. Mean follow-up (FU) time was 5.2 ± 4.7 months. Results: During the period of FU, 225 (78.9%) patients died. The 6 months- and 1 year-OS was 36.9% and 17.6%, respectively. On multivariate analysis, performance status (P < 0.001), BSBM (P < 0.001), Center (P = 0.007), RPA (P = 0.02) and GPA (P = 0.03) were statistically significant for OS. The survival prediction performances' of all indexes were identical. Noteworthy, the significant OS difference observed within 3 months of diagnosis between the BSBM, RPA and GPA classes/groups was not observed after this cut-off time point. Harrell's concordance indexes C were 0.58, 0.61 and 0.58 for the GPA, BSBM and RPA, respectively. Conclusions: Our data suggest that the new GPA index is a valid prognostic index. In this prospective study, the prediction performance was as good as the BSBM or RPA systems. These published indexes may however have limited long term prognostication capability.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
Keywords
Metàstasi cerebral
Índex pronòstic
Grup d'Oncologia de Radioteràpia
Puntuació pronòstica
Anàlisi de particions recursives
Metástasis cerebral
Índice de pronóstico
Grupo de Oncología Radioterápica
Puntuación de pronóstico
Análisis de partición recursiva
Brain Metastasis
Prognostic Index
Radiation Therapy Oncology Group
Prognostic Score
Recursive Partitioning Analysis
Pages
8
Publisher
Springer Nature
Collection
6
Is part of
Radiation Oncology
Citation
Villà, Salvador; Weber, Damien C.; Moretones, Cristina [et al.]. Validation of the new graded prognostic assessment scale for brain metastases: a multicenter prospective study. Radiation Oncology, 2011, 6, 23. Disponible en: <https://ro-journal.biomedcentral.com/articles/10.1186/1748-717X-6-23>. Fecha de acceso: 4 abr. 2024. DOI: 10.1186/1748-717X-6-23
This item appears in the following Collection(s)
- Ciències de la Salut [725]
Rights
This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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