A new updated prognostic index for patients with brain metastases (BMs) treated with palliative whole brain radiotherapy (WBRT) in the era of precision oncology. METASNCore project.

Autor: Flores-Paco P; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Vargas-Aliaga A; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Guevara MG; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Lopera I; Medical School, University of Cordoba, Cordoba, Spain., Ruiz LR; Radiation Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., López-Herrero M; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Camús JA; Radiation Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., López-González J; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Inga-Saavedra E; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Montero M; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Barneto I; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Gómez-España MA; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Ruiz E; Radiation Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Ruza M; Radiation Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Armenta A; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., Palacios A; Radiation Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain., De La Haba-Rodríguez JR; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain. juahaba@gmail.com.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain. juahaba@gmail.com.; Medical School, University of Cordoba, Cordoba, Spain. juahaba@gmail.com.; Medical Oncology Department, Hospital Universitario Reina Sofía, Av. Menendez Pidal, s/n, 14004, Córdoba, Spain. juahaba@gmail.com., Aranda E; Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.; Medical School, University of Cordoba, Cordoba, Spain.
Jazyk: angličtina
Zdroj: Journal of neuro-oncology [J Neurooncol] 2024 May; Vol. 167 (3), pp. 407-413. Date of Electronic Publication: 2024 Mar 27.
DOI: 10.1007/s11060-024-04618-1
Abstrakt: Introduction: Palliative WBRT is the main treatment for multiple BMs. Recent studies report no benefit in survival after WBRT compared to palliative supportive care in patients (pts) with poor prognosis. A new era of systemic treatment strategies based on targeted therapies are improving the prognosis of patients with BMs. The purpose of this study is to develop a prognostic score in palliative pts with BMs who undergo WBRT in this new setting.
Methods: 239 pts with BMs who received palliative WBRT between 2013-2022 in our center were analyzed retrospectively. The score was designed according to the value of the β coefficient of each variable with statistical significance in the multivariate model using Cox regression. Once the score was established, a comparison was performed according to Kaplan-Meier and was analyzed by log-rank test.
Results: 149 pts (62.3%) were male and median (m) age was 60 years. 139 (58,2%) were lung cancer and 35 (14,6%) breast cancer. All patients received 30Gys in 10 sessions. m overall survival (OS) was 3,74 months (ms). 37 pts (15,5%) had a specific target mutation. We found that 62 pts were in group < 4 points with mOS 6,89 ms (CI 95% 3,18-10,62), 84 in group 4-7 points with mOS 4,01 ms (CI 95% 3,40-4,62) and 92 pts in group > 7 points with mOS 2,72 ms (CI 95% 1,93-3,52) (p < 0,001).
Conclusions: METASNCore items are associated with OS and they could be useful to select palliative pts to receive WBRT. More studies are necessary to corroborate our findings.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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