Denise Bernhardt1, Laila König2, Sophie Aufderstrasse3, Johannes Krisam4, Juliane Hoerner-Rieber3, Sebastian Adeberg5, Farastuk Bozorgmehr6, Rami El Shafie3, Kristin Lang3, Jutta Kappes7, Michael Thomas6, Felix Herth7, Claus Peter Heußel8, Arne Warth9, Samuel Marcrom10, Jürgen Debus5, Martin Steins11, Stefan Rieken2. 1. University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany. Electronic address: denise.bernhardt@med.uni-heidelberg.de. 2. University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany. 3. University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany. 4. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany. 5. University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany. 6. Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany; Member of the German Centre for Lung Research (DZL), Heidelberg, Germany. 7. Department of Pneumology, Thoraxklinik, Heidelberg University, Heidelberg, Germany; Member of the German Centre for Lung Research (DZL), Heidelberg, Germany. 8. Member of the German Centre for Lung Research (DZL), Heidelberg, Germany; Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Diagnostic and Interventional Radiology at University of Heidelberg, Heidelberg, Germany. 9. Member of the German Centre for Lung Research (DZL), Heidelberg, Germany; Institute of Pathology, Heidelberg University, Heidelberg, Germany. 10. Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL. 11. Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany.
Abstract
INTRODUCTION: Patients with small-cell lung cancer (SCLC) demonstrate an exception in the treatment of brain metastases (BM), because in patients with SCLC whole brain radiotherapy (WBRT) only is the preferred treatment modality. The purpose of this study was to develop a prognostic score for patients with brain metastases from SCLC treated with WBRT. PATIENTS AND METHODS: The present study was conducted utilizing a single-institution, previously described, retrospective database of patients with SCLC who were treated with WBRT (n = 221). Univariate and multivariate analyses were performed to generate the "brain metastases from SCLC score" (BMS score) based on favorable prognostic factors: Karnofsky performance status (KPS > 70), extracerebral disease status (stable disease/controlled), and time of appearance of BM (synchronous). Furthermore, the disease-specific graded prognostic assessment score as well as the recursive partitioning analysis (RPA) were performed and compared with the new BMS score by using the log-rank (Mantel-Cox) test. RESULTS: BMS score and RPA showed the most significant differences between classes (P < .001). BMS score revealed a mean overall survival (OS) of 2.62 months in group I (0-1 points), 6.61 months in group II (2-3 points), and 12.31 months in group III (4 points). The BMS score also identified the group with the shortest survival (2.62 months in group I), and the numbers of patients in each group were most equally distributed with the BMS score. CONCLUSION: The new BMS score was more prognostic than the RPA and disease-specific graded prognostic assessment scores. The BMS score is easy to use and reflects known prognostic factors in contemporary patients with SCLC treated with WBRT. Future studies are necessary to validate these findings.
INTRODUCTION:Patients with small-cell lung cancer (SCLC) demonstrate an exception in the treatment of brain metastases (BM), because in patients with SCLC whole brain radiotherapy (WBRT) only is the preferred treatment modality. The purpose of this study was to develop a prognostic score for patients with brain metastases from SCLC treated with WBRT. PATIENTS AND METHODS: The present study was conducted utilizing a single-institution, previously described, retrospective database of patients with SCLC who were treated with WBRT (n = 221). Univariate and multivariate analyses were performed to generate the "brain metastases from SCLC score" (BMS score) based on favorable prognostic factors: Karnofsky performance status (KPS > 70), extracerebral disease status (stable disease/controlled), and time of appearance of BM (synchronous). Furthermore, the disease-specific graded prognostic assessment score as well as the recursive partitioning analysis (RPA) were performed and compared with the new BMS score by using the log-rank (Mantel-Cox) test. RESULTS: BMS score and RPA showed the most significant differences between classes (P < .001). BMS score revealed a mean overall survival (OS) of 2.62 months in group I (0-1 points), 6.61 months in group II (2-3 points), and 12.31 months in group III (4 points). The BMS score also identified the group with the shortest survival (2.62 months in group I), and the numbers of patients in each group were most equally distributed with the BMS score. CONCLUSION: The new BMS score was more prognostic than the RPA and disease-specific graded prognostic assessment scores. The BMS score is easy to use and reflects known prognostic factors in contemporary patients with SCLC treated with WBRT. Future studies are necessary to validate these findings.
Authors: Chad G Rusthoven; Masaaki Yamamoto; Denise Bernhardt; Derek E Smith; Dexiang Gao; Toru Serizawa; Shoji Yomo; Hitoshi Aiyama; Yoshinori Higuchi; Takashi Shuto; Atsuya Akabane; Yasunori Sato; Ajay Niranjan; Andrew M Faramand; L Dade Lunsford; James McInerney; Leonard C Tuanquin; Brad E Zacharia; Veronica Chiang; Charu Singh; James B Yu; Steve Braunstein; David Mathieu; Charles J Touchette; Cheng-Chia Lee; Huai-Che Yang; Ayal A Aizer; Daniel N Cagney; Michael D Chan; Douglas Kondziolka; Kenneth Bernstein; Joshua S Silverman; Inga S Grills; Zaid A Siddiqui; Justin C Yuan; Jason P Sheehan; Diogo Cordeiro; Kename Nosaki; Takahashi Seto; Christopher P Deibert; Vivek Verma; Samuel Day; Lia M Halasz; Ronald E Warnick; Daniel M Trifiletti; Joshua D Palmer; Albert Attia; Benjamin Li; Christopher P Cifarelli; Paul D Brown; John A Vargo; Stephanie E Combs; Kerstin A Kessel; Stefan Rieken; Samir Patel; Matthias Guckenberger; Nicolaus Andratschke; Brian D Kavanagh; Tyler P Robin Journal: JAMA Oncol Date: 2020-07-01 Impact factor: 31.777
Authors: Denise Bernhardt; Adriane Hommertgen; Daniela Schmitt; Rami El Shafie; Angela Paul; Laila König; Johanna Mair-Walther; Johannes Krisam; Christina Klose; Thomas Welzel; Juliane Hörner-Rieber; Jutta Kappes; Michael Thomas; Claus Peter Heußel; Martin Steins; Meinhard Kieser; Jürgen Debus; Stefan Rieken Journal: Trials Date: 2018-07-16 Impact factor: 2.279