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A New Scoring Tool to Assess Overall Survival in Patients With Intracerebral Metastases From Gynecological Cancers
  1. Dirk Rades, MD*,
  2. Stefan Janssen, MD*,,
  3. Amira Bajrovic, MD,
  4. Theo Veninga, MD§,
  5. Dorothea Fischer, MD, and
  6. Steven E. Schild, MD#
  1. *Department of Radiation Oncology, University of Lubeck, Lubeck;
  2. Medical Practice for Radiotherapy and Radiation Oncology, Hannover;
  3. Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
  4. §Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands;
  5. Department of Gynecology and Obstetrics, University of Lubeck, Lubeck;
  6. Department of Gynecology and Obstetrics, Ernst von Bergmann Hospital, Potsdam, Germany; and
  7. #Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, Arizona.
  1. Address correspondence and reprint requests to Dirk Rades, MD, PhD, Department of Radiation Oncology, University of Lubeck, Ratzeburger Allee 160, D-23562 Lubeck, Germany. E-mail: Rades.Dirk@gmx.net.

Abstract

Objective This study aimed to facilitate individualized treatment strategies for intracerebral metastases from gynecological cancers by creating a specific overall survival (OS) score.

Methods/Materials Fifty-six patients irradiated for cerebral metastases from gynecological cancers were included. Eleven factors were retrospectively analyzed for OS: age, Eastern Cooperative Oncology Group (ECOG) performance score, cancer type, histology, histologic grading, initial stage, number of lesions, extracerebral metastases, time between cancer diagnosis and brain metastases treatment, recursive partitioning analysis class, and type of treatment. Independent predictors of OS were incorporated in the score (better OS, 1 point; worse OS, 0 points).

Results On Cox proportional hazards analysis, performance score (hazards ratio, 1.98; 95% confidence interval, 1.30–3.23; P = 0.001), no extracerebral metastases (3.34; 1.46–8.96; P = 0.003), and recursive partitioning analysis class 1 (3.27; 1.97–5.65; P < 0.001) were significant. The following points were assigned: ECOG score 1 to 2 = 1 point, ECOG score 3 to 4 = 0 points, no extracerebral metastases = 1 point, extracerebral metastases = 0 points. Sum scores were 0 (n = 32), 1 (n = 15), or 2 points (n = 9). Six-month OS rates were 6%, 67%, and 100%, respectively (P < 0.001).

Conclusions A predictive tool including 3 groups with significantly different OS probabilities was designed for patients with cerebral metastases from gynecological cancers. This tool will aid in choosing individual treatments.

  • Gynecological cancers
  • Brain metastases
  • Irradiation
  • Overall survival
  • Scoring tool

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Footnotes

  • The authors declare no conflicts of interest.

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