A new instrument for predicting survival of patients with cerebral metastases from breast cancer developed in a homogeneously treated cohort
Abstract
Background: 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.
Methods: Characteristics showing significant (p<0.05) associations with OS on univariate analysis or almost significant (p<0.055) associations 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.
Results: On univariate analyses, better OS was significantly associated with KPS >70% (p<0.001) and absence of extra-cerebral metastases (p=0.001). On multivariate analysis, KPS was significant (p<0.001); time between breast cancer diagnosis and WBRT was almost significant (p=0.053). 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).
Conclusions: 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.
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Radiology and Oncology (ISSN 1318-2099) is a multidisciplinary journal devoted to-the publishing of original and high quality articles in diagnostic and interventional radiology, computerized tomography, ultrasound, magnetic resonance, nuclear medicine, radiotherapy, clinical and experimental oncology, radiobiology, radiophysics, and radiation protection. Therefore, the scope of the journal is to cover beside radiology diagnostic and therapeutic aspects in oncology, which distinguishes it from other journals in the field.
Open access on the web: ISSN 1518-3207 Versita Open Radiology and Onkology
