External validation of the lung-molGPA to predict survival in patients treated with stereotactic radiotherapy for brain metastases of non-small cell lung cancer.

Autor: Crouzen JA; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands., Mast ME; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands., Hakstege M; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands., Broekman MLD; Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands., Baladi C; Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands., Mertens BJA; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands., Nandoe Tewarie RDS; Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands., Kerkhof M; Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands., Vos MJ; Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands., Maas KW; Department of Pulmonology, Haaglanden Medical Center, The Hague, The Netherlands., Souwer ETD; Department of Medical Oncology, Haaglanden Medical Center, The Hague, The Netherlands., Wiggenraad RGJ; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands., van der Voort van Zyp NCMG; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands., Kiderlen M; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands., Petoukhova AL; Department of Medical Physics, Haaglanden Medical Center, The Hague, The Netherlands., Zindler JD; Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands; Department of Radiotherapy, HollandPTC, Delft, The Netherlands. Electronic address: j.zindler@haaglandenmc.nl.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Sep; Vol. 198, pp. 110405. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1016/j.radonc.2024.110405
Abstrakt: Background: In the era of personalized medicine, individualized prognostic models with tumor characteristics are needed to inform patients about survival. Before clinical use, external validation of such models by an independent group is needed. An updated version of the graded prognostic assessment (GPA) estimates survival in patients with brain metastases (BMs) of non-small cell lung cancer (NSCLC). This is the first external validation of the updated Lung-molGPA in patients treated with stereotactic radiotherapy (SRT) for one or more BMs.
Materials and Methods: Patients treated with SRT for BMs from NSCLC adenocarcinoma were retrospectively included. GPA score was calculated for each patient based on six prognostic factors including age, Karnofsky Performance Status, number of BMs, extracranial metastases, EGFR/ALK status, and PD-L1 expression. Kaplan-Meier analysis evaluated survival probability. Impact of individual prognostic factors on survival was assessed by univariate and multivariate analyses using the Cox proportional hazard model. Predictive performance was evaluated using discrimination (C-statistic) and calibration (Brier test).
Results: The cohort (n = 241) was divided into four prognostic groups. Overall median survival was 15 months. Predicted and observed median survival were similar between the original and validation cohorts, apart from the most favorable prognostic group. With adequate C-statistics and Brier scores, the Lung-molGPA provided accurate survival predictions.
Conclusion: The Lung-molGPA accurately predicted survival in our European population, except for an overestimation of survival in the small most favorable prognostic group. This prognostic model was externally validated and is therefore useful for counseling of patients with BMs of NSCLC adenocarcinoma.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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