Dirk Rades1, Trang Nguyen2, Oliver Blanck3, Steven E Schild4. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net. 2. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 3. Saphir Radiosurgery Center Northern Germany, Güstrow, Germany. 4. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Abstract
BACKGROUND/AIM: Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have gained popularity especially for treating 1-3 cerebral metastases. Elderly patients benefit from treatment personalisation. A specific survival score was created to facilitate this approach. PATIENTS AND METHODS: Ten characteristics were retrospectively analysed for survival in 104 elderly patients with 1-3 cerebral metastases receiving SRS or FSRT alone using a linear accelerator or Cyberknife®. RESULTS: On multivariate analysis, better survival was significantly associated with KPS of 90-100 (p=0.049), single lesion (p=0.036), maximum cumulative diameter of all lesions <16 mm (p=0.026) and supratentorial involvement only (p=0.047). Three groups were formed with 12-14 points (n=22), 15-16 points (n=33) and 17-19 points (n=49) with 12-month survival rates of 7%, 34% and 58% (p<0.0001), respectively. Positive predictive values for predicting death ≤12 months and survival ≥12 months were 95% and 54%. CONCLUSION: The new score showed very high accuracy in predicting death ≤12 months, but not in predicting survival ≥12 months. Copyright
BACKGROUND/AIM: Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have gained popularity especially for treating 1-3 cerebral metastases. Elderly patients benefit from treatment personalisation. A specific survival score was created to facilitate this approach. PATIENTS AND METHODS: Ten characteristics were retrospectively analysed for survival in 104 elderly patients with 1-3 cerebral metastases receiving SRS or FSRT alone using a linear accelerator or Cyberknife®. RESULTS: On multivariate analysis, better survival was significantly associated with KPS of 90-100 (p=0.049), single lesion (p=0.036), maximum cumulative diameter of all lesions <16 mm (p=0.026) and supratentorial involvement only (p=0.047). Three groups were formed with 12-14 points (n=22), 15-16 points (n=33) and 17-19 points (n=49) with 12-month survival rates of 7%, 34% and 58% (p<0.0001), respectively. Positive predictive values for predicting death ≤12 months and survival ≥12 months were 95% and 54%. CONCLUSION: The new score showed very high accuracy in predicting death ≤12 months, but not in predicting survival ≥12 months. Copyright
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