Masaaki Yamamoto1, Takuya Kawabe2, Yoshinori Higuchi3, Yasunori Sato4, Tadashi Nariai5, Shinya Watanabe6, Bierta E Barfod7, Hidetoshi Kasuya8. 1. Katsuta Hospital Mito GammaHouse, Hitachi-naka, Japan; Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan. Electronic address: BCD06275@nifty.com. 2. Katsuta Hospital Mito GammaHouse, Hitachi-naka, Japan; Department of Neurosurgery, Kyoto Prefectural University of Medicine Graduate School of Medical Sciences, Kyoto, Japan. 3. Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. 4. Clinical Research Center, Chiba University Graduate School of Medicine, Chiba, Japan. 5. Department of Neurosurgery, Graduate School, Tokyo Medical and Dental University School of Medicine, Tokyo, Japan. 6. Katsuta Hospital Mito GammaHouse, Hitachi-naka, Japan; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 7. Katsuta Hospital Mito GammaHouse, Hitachi-naka, Japan. 8. Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Abstract
OBJECTIVES: We tested the validity of 5 prognostic indices, Recursive Partitioning Analysis (RPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM), Graded Prognostic Assessment (GPA), and Modified-RPA, for patients who underwent repeat stereotactic radiosurgery (re-SRS). METHODS: For this study, we used our database, which included 804 patients who underwent gamma knife re-SRS during the period 1998-2013. RESULTS: There were statistically significant survival differences among patients stratified into 3 or 4 groups based on the 5 systems (P < 0.001). With RPA, SIR, BSBM, and the Modified-RPA, there were statistically significant median survival time (MST) differences between any 2 pairs within the 3/4 groups. With the GPA system, however, the MST difference between the GPA 3.5-4.0 and GPA 3.0 groups did not reach statistical significance (P = 0.48). There were large patient number discrepancies among the 3/4 groups in the RPA, SIR, BSBM, and GPA whereas patient numbers were very similar among the 3 Modified-RPA system groups. Our present results show the RPA and BSBM systems to reflect changes less well, with 86%-95% of patients remaining in the same categories between the first and second SRS procedures. However, with SIR, GPA, and the Modified-RPA, 25%-31% of patients were categorized into different subclasses, either better or worse. With the modified-RPA system, such categorical change correlated well with post-re-SRS MSTs. CONCLUSIONS: Among the 5 systems, based on patient number proportions, MST separation among the 3/4 groups, and/or detailed reflection of status changes, the Modified-RPA system was shown to be most applicable to re-SRS patients.
OBJECTIVES: We tested the validity of 5 prognostic indices, Recursive Partitioning Analysis (RPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM), Graded Prognostic Assessment (GPA), and Modified-RPA, for patients who underwent repeat stereotactic radiosurgery (re-SRS). METHODS: For this study, we used our database, which included 804 patients who underwent gamma knife re-SRS during the period 1998-2013. RESULTS: There were statistically significant survival differences among patients stratified into 3 or 4 groups based on the 5 systems (P < 0.001). With RPA, SIR, BSBM, and the Modified-RPA, there were statistically significant median survival time (MST) differences between any 2 pairs within the 3/4 groups. With the GPA system, however, the MST difference between the GPA 3.5-4.0 and GPA 3.0 groups did not reach statistical significance (P = 0.48). There were large patient number discrepancies among the 3/4 groups in the RPA, SIR, BSBM, and GPA whereas patient numbers were very similar among the 3 Modified-RPA system groups. Our present results show the RPA and BSBM systems to reflect changes less well, with 86%-95% of patients remaining in the same categories between the first and second SRS procedures. However, with SIR, GPA, and the Modified-RPA, 25%-31% of patients were categorized into different subclasses, either better or worse. With the modified-RPA system, such categorical change correlated well with post-re-SRS MSTs. CONCLUSIONS: Among the 5 systems, based on patient number proportions, MST separation among the 3/4 groups, and/or detailed reflection of status changes, the Modified-RPA system was shown to be most applicable to re-SRS patients.
Authors: Deborah C Marshall; Logan P Marcus; Teddy E Kim; Brandon A McCutcheon; Steven J Goetsch; Takao Koiso; John F Alksne; Kenneth Ott; Bob S Carter; Jona A Hattangadi-Gluth; Masaaki Yamamoto; Clark C Chen Journal: J Neurooncol Date: 2016-03-07 Impact factor: 4.130
Authors: Timothy Malouff; Nathan R Bennion; Vivek Verma; Gabriel A Martinez; Nathan Balkman; Abhijeet Bhirud; Tanner Smith; Chi Lin Journal: Front Oncol Date: 2016-11-21 Impact factor: 6.244
Authors: Corinna Fritz; Kim Borsky; Luisa S Stark; S Tanadini-Lang; Stephanie G C Kroeze; Jérôme Krayenbühl; Matthias Guckenberger; Nicolaus Andratschke Journal: Front Oncol Date: 2018-11-22 Impact factor: 6.244