<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2019-0020_s_005_w2aab3b7b7b1b6b1aab1c18b1Aa"><h3>Background</h3><p>Previous survival scores for breast cancer patients with cerebral metastases were developed in cohorts receiving heterogeneous treatments, which could have introduced selection biases. A new instrument (WBRT-30-BC) was created from 170 patients receiving whole-brain radiotherapy (WBRT) alone with 30 Gy in 10 fractions.</p></sec><sec id="j_raon-2019-0020_s_006_w2aab3b7b7b1b6b1aab1c18b2Aa"><h3>Methods</h3><p>Characteristics showing significant associations (p &lt; 0.05) with overall survival (OS) or a trend (p &lt; 0.08) on multivariate analysis were used for the WBRT-30-BC. For each characteristic, 6-month OS rates were divided by 10. These scoring points were added for each patient (patient scores). The WBRT-30-BC was compared to the diagnosis- specific graded prognostic assessment (DS-GPA) classification and Rades-Score for breast cancer regarding positive predictive values (PPVs) to identify patients dying within 6 months and patients surviving at least 6 months following WBRT.</p></sec><sec id="j_raon-2019-0020_s_007_w2aab3b7b7b1b6b1aab1c18b3Aa"><h3>Results</h3><p>On multivariate analysis, Karnofsky performance score (KPS) was significant (risk ratio [RR]: 2.45, p &lt; 0.001). In addition, extra-cerebral metastatic disease (RR: 1.52, p = 0.071) and time between breast cancer diagnosis and WBRT (RR: 1.37, p = 0.070) showed a trend. Based on these three characteristics, four predictive groups were designed: 7–9, 10–12, 13–15 and 16 points. Six-month OS rates were 8%, 41%, 68% and 100% (p &lt; 0.001). PPVs to identify patients dying within 6 months were 92% (WBRT-30-BC), 84% (DS-GPA) and 92% (Rades-Score). PPVs to identify patients surviving for at least 6 months were 100% (WBRT-30-BC), 74% (DS-GPA) and 68% (Rades-Score).</p></sec><sec id="j_raon-2019-0020_s_008_w2aab3b7b7b1b6b1aab1c18b4Aa"><h3>Conclusions</h3><p>The WBRT-30-BC appeared very accurate in predicting death ≤ 6 months and survival ≥ 6 months of breast cancer patients receiving WBRT. It was superior to previous instruments in predicting survival ≥ 6 months.</p></sec></abstract>

BackgroundPrevious survival scores for breast cancer patients with cerebral metastases were developed in cohorts receiving heterogeneous treatments, which could have introduced selection biases. A new instrument (WBRT-30-BC) was created from 170 patients receiving whole-brain radiotherapy (WBRT) alone with 30 Gy in 10 fractions.MethodsCharacteristics showing significant associations (p < 0.05) with overall survival (OS) or a trend (p < 0.08) on multivariate analysis were used for the WBRT-30-BC. For each characteristic, 6-month OS rates were divided by 10. These scoring points were added for each patient (patient scores). The WBRT-30-BC was compared to the diagnosis- specific graded prognostic assessment (DS-GPA) classification and Rades-Score for breast cancer regarding positive predictive values (PPVs) to identify patients dying within 6 months and patients surviving at least 6 months following WBRT.ResultsOn multivariate analysis, Karnofsky performance score (KPS) was significant (risk ratio [RR]: 2.45, p < 0.001). In addition, extra-cerebral metastatic disease (RR: 1.52, p = 0.071) and time between breast cancer diagnosis and WBRT (RR: 1.37, p = 0.070) showed a trend. Based on these three characteristics, four predictive groups were designed: 7–9, 10–12, 13–15 and 16 points. Six-month OS rates were 8%, 41%, 68% and 100% (p < 0.001). PPVs to identify patients dying within 6 months were 92% (WBRT-30-BC), 84% (DS-GPA) and 92% (Rades-Score). PPVs to identify patients surviving for at least 6 months were 100% (WBRT-30-BC), 74% (DS-GPA) and 68% (Rades-Score).ConclusionsThe WBRT-30-BC appeared very accurate in predicting death ≤ 6 months and survival ≥ 6 months of breast cancer patients receiving WBRT. It was superior to previous instruments in predicting survival ≥ 6 months.

A new instrument for predicting survival of patients with cerebral metastases from breast cancer developed in a homogeneously treated cohort

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundPrevious survival scores for breast cancer patients with cerebral metastases were developed in cohorts receiving heterogeneous treatments, which...

A new instrument for predicting survival of patients with cerebral metastases from breast cancer developed in a homogeneously treated cohort

Article Category: Research Article

Online veröffentlicht: 08. Mai 2019

Seitenbereich: 219 - 224

Eingereicht: 12. Feb. 2019

Akzeptiert: 27. März 2019

DOI: https://doi.org/10.2478/raon-2019-0020

© 2019 Stefan Janssen, Heinke C Hansen, Liesa Dziggel, Steven E Schild, Dirk Rades, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.