A scoring system for predicting the survival prognosis of patients receiving stereotactic body radiation therapy (SBRT) for 1–3 lung metastases

Kaesmann, Lukas; Rudat, Volker; Rades, Dirk

doi:10.1007/s00408-016-9906-z

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…We showed a benefit in OS for patients with a KPS ≥90%, small GTV and PTV, higher BED doses, absence of external metastases, ≤3 pulmonary metastases, and a controlled primary tumor. This prognostic impact could also be shown by other studies [6,7,25,27,30,31].…”

Section: Discussionsupporting

confidence: 80%

Stereotactic body radiotherapy (SBRT) in patients with lung metastases - prognostic factors and long-term survival using patient self-reported outcome (PRO)

et al. 2020

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Objectives: The present study aims to evaluate long-term side-effects and outcomes and confirm prognostic factors after stereotactic body radiotherapy (SBRT) of pulmonary lesions. This is the first work that combines the investigated data from patient charts and patient-reported outcome (PRO) up to 14 years after therapy. Materials and methods: We analyzed 219 patients and 316 lung metastases treated between 2004 and 2019. The pulmonary lesions received a median dose and dose per fraction of 35 Gy (range: 14-60.5 Gy) and 8 Gy (range: 3-20 Gy) to the surrounding isodose. During the last 1.5 years of monitoring, we added PRO assessment to our follow-up routine. We sent an invitation to a web-based survey questionnaire to all living patients whose last visit was more than 6 months ago. Results: Median OS was 27.6 months. Univariate analysis showed a significant influence on OS for KPS ≥90%, small gross tumor volume (GTV) and planning target volume (PTV), the absence of external metastases, ≤3 pulmonary metastases, and controlled primary tumor. The number of pulmonary metastases and age influenced local control (LC) significantly. During follow-up, physicians reported severe side-effects ≥ grade 3 in only 2.9% within the first 6 months and in 2.5% after 1 year. Acute symptomatic pneumonitis grade 2 was observed in 9.7%, as grade 3 in 0.5%. During PRO assessment, 39 patients were contacted, 38 patients participated, 14 participated twice during follow-up. Patients reported 15 cases of severe side effects (grade ≥ 3) according to PROCTCAE classification. Severe dyspnea (n = 6) was reported mostly.

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Section: Discussionsupporting

confidence: 80%

Stereotactic body radiotherapy (SBRT) in patients with lung metastases - prognostic factors and long-term survival using patient self-reported outcome (PRO)

et al. 2020

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“…Thus, the treatment of a very limited number of brain metastases has become more complex recently and requires more personalized treatment regimens. Such a personalized treatment approach should always consider a patient's survival prognosis, which has been suggested for other metastatic situations (7)(8)(9)(10)(11)(12)(13)(14). In order to facilitate the selection of the appropriate treatment regimen for a patient who is supposed receiving radiosurgery or fractionated stereotactic radiotherapy (FSRT) alone for a very limited number of brain metastases, a scoring-system that allows the physician to quickly estimate a patient's remaining survival time is helpful.…”

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confidence: 99%

“…On the multivariate analysis of the previous study, three factors were found to be significantly associated with survival. These factors were age at the time of radiotherapy (≤60 versus ≥61 years), Eastern Cooperative Oncology Group (ECOG) performance score (0-1 versus 2) and extra-cranial metastases (no versus yes) (12). For each of these three factors, the 1-year survival rates in % were divided by 10, and subsequently, the three scoring-points were summed to generate the prognostic score for a specific patient.…”

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confidence: 99%

Validation of a Survival Score for Patients Receiving Radiosurgery or Fractionated Stereotactic Radiotherapy for 1 to 3 Brain Metastases

Rades

Blanck

Khoa

et al. 2018

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Abstract. Background 75% versus 77% (p=0.79). Conclusion: In the more favorable group, the scoring-system was very reproducible. In the less favorable group, the difference was larger, but also not signficant.Two randomized trials compared radiosurgery alone to radiosurgery combined with whole-brain radiotherapy (WBRT) for very few brain metastases. Both found that the addition of WBRT had a negative impact on neuro-cognitive function (1, 2). Therefore, omitting WBRT has become more popular. However, on the other hand, several studies showed that WBRT resulted in significantly better intracerebral control (1-4). And one has to be aware that progressive or new brain metastases have also be associated with neurocognitive decline (4, 5). Thus, patients with a high risk of developing new brain metastases or experience a progression or recurrence of the treated lesions may benefit from the addition of WBRT.Furthermore, the increasing use of novel systemic treatments such as targeted therapies prior, during or after radiotherapy may lead to improved survival but may also damage brain tissue not affected by metastatic disease (5, 6). Thus, the treatment of a very limited number of brain metastases has become more complex recently and requires more personalized treatment regimens. Such a personalized treatment approach should always consider a patient's survival prognosis, which has been suggested for other metastatic situations (7)(8)(9)(10)(11)(12)(13)(14). In order to facilitate the selection of the appropriate treatment regimen for a patient who is supposed receiving radiosurgery or fractionated stereotactic radiotherapy (FSRT) alone for a very limited number of brain metastases, a scoring-system that allows the physician to quickly estimate a patient's remaining survival time is helpful. We have developed such a scoring-system about three years ago (15). However, this system has not yet been validated. The present study was conducted to assess the validity and reproducibility of the previously developed scoring-system. Patients and MethodsThe data of 76 new patients treated with single-fraction radiosurgery alone (n=50) or FSRT alone (n=26) for 1 to 3 brain metastases from a solid tumor were retrospectively analyzed. The characteristics of these patients are summarized in Table I. Of this cohort, 41 patients were treated with a linear accelerator and 35 patients with a

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“…Our initial search yielded 693 potentially relevant citations. After screening was completed, a total of 13 studies with 559 patients were eligible for inclusion after screening 7–19 . A PRISMA flow diagram is provided to outline the selection process (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

The role of stereotactic body radiation therapy in the management of pulmonary metastases: a systematic review

Lee

Samarasinghe

et al. 2022

Precision Radiation Oncology

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While pulmonary metastases are often managed through metastasectomies, stereotactic body radiation therapy (SBRT) is a relatively novel treatment that has shown promise for this disease. This review aimed to summarize the current findings of SBRT in the treatment of pulmonary metastases. MEDLINE, EMBASE, and CENTRAL were searched for articles that examined the use of SBRT for patients with pulmonary metastases. Primary outcomes included overall survival, disease-free survival, and progression-free survival. Results were pooled where appropriate. Risk of bias was assessed through the Methodological Index for Non-Randomized Studies tool. After screening, 13 studies with 545 patients conducted between 2006 and 2020 were

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A scoring system for predicting the survival prognosis of patients receiving stereotactic body radiation therapy (SBRT) for 1–3 lung metastases

Abstract: A survival scoring system for patients receiving SBRT for very few lung metastases was developed. This score allowed us to estimate the survival prognosis of these patients and can aid physicians when aiming to choose the optimal SBRT dose for individual patients.

Cited by 5 publications

References 12 publications

Stereotactic body radiotherapy (SBRT) in patients with lung metastases - prognostic factors and long-term survival using patient self-reported outcome (PRO)

Stereotactic body radiotherapy (SBRT) in patients with lung metastases - prognostic factors and long-term survival using patient self-reported outcome (PRO)

Validation of a Survival Score for Patients Receiving Radiosurgery or Fractionated Stereotactic Radiotherapy for 1 to 3 Brain Metastases

The role of stereotactic body radiation therapy in the management of pulmonary metastases: a systematic review

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