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

  • Dirk Rades Department of Radiation Oncology University of Lübeck

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.

Author Biography

Dirk Rades, Department of Radiation Oncology University of Lübeck

Current Position:

Chair of the Department of Radiation Oncology,

University of Lübeck

Head of the Department of Radiation Oncology,

University Hospital Schleswig-Holstein, Campus Lübeck

 

Further appointments:

2005-07                         Expert and Consultant of International Atomic Energy Agency (IAEA)

2007-16                         Chairman of the Palliative Radiotherapy Group of the German Society for Radiation Oncology (DEGRO)

since 2007                    Member of several committees of the American Society for Therapeutic Radiology and Oncology (ASTRO)

2008 + 2009                  Visiting Professor, University of Bergen, Norway

since 2010                    Reviewer for the UICC (Union for International Cancer Control)

since 2010                    Reviewer for the European Union

2016                              Visiting Lecturer, Harvard Medical School Boston, USA

2017                              Visiting Professor, University of Ottawa, Canada

 

Awards / Honorary Memberships

2008                              Honorary Member, Belgian Society for Radiation Oncology

2008                              Award, German Cancer Society, Studies in Radiation Oncology

2010                              Honorary Member, Armenian Association for Radiation Oncology and Radiology

2011                              Honorary Member, Georgian Association for Radiation Oncology

2012                              Honorary Member, Slovenian Society for Radiation Oncology

2012                              Honorary Member, Romanian Society for Radiation Oncology and Medical Oncology

2012                              Eminent Scientist of the Year Award Europe of the IRPC

2013                              Honorary Professor, Hanoi Medical University, Vietnam

2015                              Honorary Member, Spanish Society for Radiation Oncology

2016                              Honorary Professor, Haiphong University of Medicine and Pharmacy, Vietnam

2018                              1st Research Medal, Cancer Society of Schleswig-Holstein

Published
2019-06-06
How to Cite
Rades, D. (2019). A new instrument for predicting survival of patients with cerebral metastases from breast cancer developed in a homogeneously treated cohort. Radiology and Oncology, 53(2), 219-224. Retrieved from https://radioloncol.com/index.php/ro/article/view/3222
Section
Clinical oncology