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Prognostic factors for brain metastases after
whole brain radiotherapy. Data from a single institution
Fleckenstein K, Hof H, Lohr F, Wenz F, Wannenmacher M
Department of Radiation Oncology, University Hospital
Mannheim-University of Heidelberg, Germany.
katharina.fleckenstein@radonk.ma.uni-heidelberg.de
Purpose.
Prognostic
factors for overall survival of patients treated for brain metastases with whole
brain radiotherapy (WBRT) at a single institution were retrospectively
evaluated, and the validity of the RTOG recursive partitioning analysis (RPA)
for prognostic classes was assessed.
Patients and Methods.
The data of all patients (n = 268) with brain metastases from solid tumors
homogeneously treated between 01/1997 and 09/1999 at the University of
Heidelberg, Germany, with WBRT without surgery or radiosurgery were
reviewed.
13 different patient- and therapy-related variables were evaluated for
prognosis.
Second, a grouping of the study cohort was performed according to the RTOG RPA
prognostic classes.
Results.
Median survival
of the whole population after the start of WBRT was 3.8 months.
The 1-year survival rate was 19%.
Multivariate analysis revealed that only the Karnofsky performance status,
control of the primary and no extracranial disease were independent prognostic
factors for overall survival.
These are also the main determinants of the RTOG RPA classes.
Applying the RTOG RPA classes to the authors' data set revealed three subgroups
with significantly different prognosis.
Conclusion.
Based on
this analysis, prognostic factors for survival after WBRT in patients with brain
metastases could be identified.
A total of 19% (n = 44/232) survived > or = 1 year, whereas overall survival
was poor.
The potential value of the RPA classes in estimating the patient's prognosis
could be confirmed.
PMID: 15127156 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15127156
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