Score Index for Stereotactic Radiosurgery of Brain Metastases

Weltman, Eduardo; Salvajoli, João Víctor; Oliveira, Vinio Cintra e; Brandt, Reynaldo André; Cruz, José C.; Borges, Sandra Regina de Oliveira; Anselmo, Rosana Toledo Rodrigues; Wajsbrot, Dalia

doi:10.1023/b:jora.0000010892.99686.9e

Cited by 20 publications

(17 citation statements)

References 28 publications

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“…With the wide application of SRS, the number of lesions has been proved to be another independent factor in predicting prognosis18. SIR scoring was established, which was derived from a limited number of patients treated with SRS.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Prognostic Indices in NSCLC Patients with Brain Metastases after Radiosurgery

Gao¹,

Huang²,

Du³

et al. 2018

Int. J. Biol. Sci.

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Prognostic indices are commonly used in the context of brain metastases radiotherapy to guide patient decision-making and clinical trial stratification. This study is to choose an appropriate prognostic index (PI) for non-small cell lung cancer (NSCLC) patients with brain metastases (BM) who underwent radiosurgery. A total of 103 patients with BM from NSCLC receiving radiosurgery were analyzed retrospectively. There are six prognostic factors were analyzed, including age, primary tumor control, extracranial metastasis, KPS score, number of lesions, max lesion volume; and four prognostic indices were compared, include Recursive Partitioning Analysis (RPA),Graded Prognostic Assessment (GPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM). Survival curves were estimated with the Kaplan-Meier method and compared with a log-rank test stratified according to the PIs. Univariate and multivariate analysis was performed using the Cox regression analysis. The PI's predictive capacity was compared in terms of Akaike information criterion (AIC), Log-rank × 2, Concordance index (C-index) and calibration curve. The median survival time was 8 months, and the 6-months and 12-months survival rate were 61% and 26% respectively. All four prognostic indices were correlated with prognosis (P<0.005).The AIC for BSBM (686.317) was the minimum in the four PIs(range,686.317-739.113).The Log-rank × 2 value for BSBM (77.62) was the maximum in the four PIs (range,23.32-77.62).The C-index for BSBM (0.758)was superior than the other PIs predictive capacity (range,0.611-0.758). The calibration curve showed that the BSBM was able to predict 6-months and 12-months overall survival accurately. In conclusion, the BSBM may be the most accurate prognostic index for patients with BM from NSCLC who underwent radiosurgery.

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Section: Discussionmentioning

confidence: 99%

Comparison of Prognostic Indices in NSCLC Patients with Brain Metastases after Radiosurgery

Gao¹,

Huang²,

Du³

et al. 2018

Int. J. Biol. Sci.

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“…Additional treatments, such as corticosteroids, were evaluated as well. Furthermore, patients were assessed using the GPA (Graded Prognostic Assessment; general and specific for primary tumors), RPA (Recursive partitioning analysis), and SIR (Score Index for Radiosurgery) 12‐14 . To minimize the selection bias, all patients were included in the primary analysis.…”

Section: Methodsmentioning

confidence: 99%

Toxicity and efficacy of Gamma Knife radiosurgery for brain metastases in melanoma patients treated with immunotherapy or targeted therapy—A retrospective cohort study

et al. 2020

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Background: Few safety data of concurrent stereotactic radiosurgery and targeted therapy (TT) or immunotherapy (IT) are available. The aim of the study was to evaluate the outcome of melanoma patients with brain metastases (MBM) after Gamma Knife Radiosurgery (GKRS) in relation to IT/TT. Methods: We evaluated 182 MBM patients, who were treated with GKRS in the modern radiosurgical and oncological era. Results: The median time between the initial melanoma diagnosis and occurrence of MBM was 2.4 years. The median overall survival time was 5.4 years after melanoma diagnosis. The estimated median survival after the initial diagnosis of MBM was 1.0 year (95% CI = 0.7-1.2 years). Patients treated with anti-PD-1 or a combination of anti-CTLA-4/PD-1 showed a significantly longer survival after first GKRS compared to all other forms of treatment. In addition, patients treated with anti-PD-1, anti-CTLA-4, or a combination of anti-CTLA-4/PD-1 showed a significantly longer time to new MBM after GKRS1 compared to patients treated with other forms and combinations of the oncological therapy. The occurrence of hemorrhage or radiation reaction/necrosis after GKRS did not show any statistically significant differences in relation to IT/TT. Conclusion: In MBM patients, complications after GKRS are not significantly increased if IT/TT treatment is performed at the time of or after radiosurgery. Further, a clear benefit in distant control and survival is seen in MBM patients treated with GKRS and checkpoint inhibitors. Thus, concomitant treatment of MBM with GKRS and IT/TT seems to be a safe and powerful treatment option although further prospective studies should be conducted. K E Y W O R D S brain metastases, gamma knife radiosurgery, immunotherapy, melanoma, targeted therapy | 4027 GATTERBAUER ET Al.

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“…14 In this context, several prognostic scales have been developed for patients afflicted with BM. 15–17 While the specifics of these scales differ, they generally involve the same clinical variables, including age, Karnofsky Performance Score (KPS), extracranial disease status, histology, and the number of metastases. 15–17…”

mentioning

confidence: 99%

Superior Prognostic Value of Cumulative Intracranial Tumor Volume Relative to Largest Intracranial Tumor Volume for Stereotactic Radiosurgery-Treated Brain Metastasis Patients

et al. 2017

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BACKGROUND:Two intracranial tumor volume variables have been shown to prognosticate survival of stereotactic-radiosurgery-treated brain metastasis patients: the largest intracranial tumor volume (LITV) and the cumulative intracranial tumor volume (CITV). OBJECTIVE: To determine whether the prognostic value of the Scored Index for Radiosurgery (SIR) model can be improved by replacing one of its components-LITV-with CITV. METHODS:We compared LITV and CITV in terms of their survival prognostication using a series of multivariable models that included known components of the SIR: age, Karnofsky Performance Score, status of extracranial disease, and the number of brain metastases. Models were compared using established statistical measures, including the net reclassification improvement (NRI > 0) and integrated discrimination improvement (IDI). The analysis was performed in 2 independent cohorts, each consisting of ∼3000 patients. RESULTS: In both cohorts, CITV was shown to be independently predictive of patient survival. Replacement of LITV with CITV in the SIR model improved the model's ability to predict 1-yr survival. In the first cohort, the CITV model showed an NRI > 0 improvement of 0.2574 (95% confidence interval [CI] 0.1890-0.3257) and IDI of 0.0088 (95% CI 0.0057-0.0119) relative to the LITV model. In the second cohort, the CITV model showed a NRI > 0 of 0.2604 (95% CI 0.1796-0.3411) and IDI of 0.0051 (95% CI 0.0029-0.0073) relative to the LITV model. CONCLUSION: After accounting for covariates within the SIR model, CITV offers superior prognostic value relative to LITV for stereotactic radiosurgery-treated brain metastasis patients.

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Score Index for Stereotactic Radiosurgery of Brain Metastases

Cited by 20 publications

References 28 publications

Comparison of Prognostic Indices in NSCLC Patients with Brain Metastases after Radiosurgery

Comparison of Prognostic Indices in NSCLC Patients with Brain Metastases after Radiosurgery

Toxicity and efficacy of Gamma Knife radiosurgery for brain metastases in melanoma patients treated with immunotherapy or targeted therapy—A retrospective cohort study

Superior Prognostic Value of Cumulative Intracranial Tumor Volume Relative to Largest Intracranial Tumor Volume for Stereotactic Radiosurgery-Treated Brain Metastasis Patients

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