Advances in Neuroscience / 2015 / Article / Tab 2

Review Article

Contemporary Review of the Management of Brain Metastasis with Radiation

Table 2

(a) Median survival according to RPA class following WBRT [26]. (b) RTOG Graded Prognostic Assessment (GPA) is felt to be a more sensitive tool for predicting outcomes in BrM patients. They are assigned a score of 0, 0.5, or 1 for each of 4 characteristics. The sum of the score predicts median survival both as a whole (RTOG MS) and with therapy such as WBRT ± SRS [27]. (c) Disease Specific GPA [28].
(a)

Treatment Patients ()Median survival (months) by RPA class
Class 1
(Primary controlled, age <65, no extracranial metastases, KPS ≥ 70)
Class 2
(primary uncontrolled OR age ≥65, OR extracranial metastases)
Class 3
(KPS < 70)

WBRT (RTOG phase III trials)11767.14.22.3

(b)

Score00.51Sum GPA scoreRTOG MS WBRT and/or SRS MS

Age>6050–59<503.5–411.021.7
KPS<7070–8090–10036.917.5
Number brain mets>32-311.5–2.53.85.9
ExtraCNS metsPresentNone0-12.63.0

MS = median survival (months).
(c)

PrimaryMedian survival (Months)95% CI

Non-small-cell lung cancer7.006.53–7.50
Small cell lung cancer4.904.30–6.20
Melanoma6.745.90–7.57
Renal cell carcinoma9.637.66–10.91
Breast cancer11.939.69–12.85
Gastrointestinal cancer5.364.30–6.30
Unknown6.375.22–7.49

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