Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Brain Prognostic Factors
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Brain Prognostic Scores
3.3. Survival Outcome
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Sacks, P.; Rahman, M. Epidemiology of Brain Metastases. Neurosurg. Clin. N. Am. 2020, 31, 481–488. [Google Scholar] [CrossRef]
- Pérez-Larraya, J.G.; Hildebrand, J. Brain metastases. Handb. Clin. Neurol. 2014, 121, 1143–1157. [Google Scholar] [CrossRef]
- Habets, E.J.; Dirven, L.; Wiggenraad, R.G.; Kanter, A.V.-D.; Nijeholt, G.J.L.; Zwinkels, H.; Klein, M.; Taphoorn, M.J. Neurocognitive functioning and health-related quality of life in patients treated with stereotactic radiotherapy for brain metastases: A prospective study. Neuro-Oncology 2015, 18, 435–444. [Google Scholar] [CrossRef] [PubMed]
- Lu-Emerson, C.; Eichler, A.F. Brain Metastases. Contin. Lifelong Learn. Neurol. 2012, 18, 295–311. [Google Scholar] [CrossRef] [PubMed]
- Choi, A.; Hunting, J.; Lanier, C.; Douglas, E.; Triozzi, P.; Ruiz, J.; Benayoun, M.; White, J.; Chan, M. Treatment Options for Brain Metastases. Curr. Treat. Options Oncol. 2024, 25, 1011–1026. [Google Scholar] [CrossRef]
- Gondi, V.; Bauman, G.; Bradfield, L.; Burri, S.H.; Cabrera, A.R.; Cunningham, D.A.; Eaton, B.R.; Hattangadi-Gluth, J.A.; Kim, M.M.; Kotecha, R.; et al. Radiation Therapy for Brain Metastases: An ASTRO Clinical Practice Guideline. Pr. Radiat. Oncol. 2022, 12, 265–282. [Google Scholar] [CrossRef]
- Lin, X.; DeAngelis, L.M. Treatment of Brain Metastases. J. Clin. Oncol. 2015, 33, 3475–3484. [Google Scholar] [CrossRef] [PubMed]
- Le Rhun, E.; Guckenberger, M.; Smits, M.; Dummer, R.; Bachelot, T.; Sahm, F.; Galldiks, N.; de Azambuja, E.; Berghoff, A.; Metellus, P.; et al. EANO–ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours. Ann. Oncol. 2021, 32, 1332–1347. [Google Scholar] [CrossRef] [PubMed]
- Ceddia, S.; Codacci-Pisanelli, G. Treatment of brain metastases in ALK-positive non-small cell lung cancer. Crit. Rev. Oncol. 2021, 165, 103400. [Google Scholar] [CrossRef]
- Hui, C.; Qu, V.; Wang, J.-Y.; von Eyben, R.; Chang, Y.-C.; Chiang, P.-L.; Liang, C.-H.; Lu, J.-T.; Li, G.; Hayden-Gephart, M.; et al. Local control of brain metastases with osimertinib alone in patients with EGFR-mutant non-small cell lung cancer. J. Neuro-Oncol. 2022, 160, 233–240. [Google Scholar] [CrossRef] [PubMed]
- Brenner, A.W.; Patel, A.J. Review of Current Principles of the Diagnosis and Management of Brain Metastases. Front. Oncol. 2022, 12, 857622. [Google Scholar] [CrossRef]
- Sperduto, P.W.; Mesko, S.; Li, J.; Cagney, D.; Aizer, A.; Lin, N.U.; Nesbit, E.; Kruser, T.J.; Chan, J.; Braunstein, S.; et al. Survival in Patients with Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient. J. Clin. Oncol. 2020, 38, 3773–3784. [Google Scholar] [CrossRef] [PubMed]
- Sperduto, C.M.; Watanabe, Y.; Mullan, J.; Hood, T.; Dyste, G.; Watts, C.; Bender, G.P.; Sperduto, P. A validation study of a new prognostic index for patients with brain metastases: The Graded Prognostic Assessment. J. Neurosurg. 2008, 109, 87–89. [Google Scholar] [CrossRef]
- Sperduto, P.W.; Berkey, B.; Gaspar, L.E.; Mehta, M.; Curran, W. A New Prognostic Index and Comparison to Three Other Indices for Patients with Brain Metastases: An Analysis of 1,960 Patients in the RTOG Database. Int. J. Radiat. Oncol. 2007, 70, 510–514. [Google Scholar] [CrossRef] [PubMed]
- Nieder, C.; Mehta, M.P.; Geinitz, H.; Grosu, A.L. Prognostic and predictive factors in patients with brain metastases from solid tumors: A review of published nomograms. Crit. Rev. Oncol. 2018, 126, 13–18. [Google Scholar] [CrossRef] [PubMed]
- Sperduto, P.W.; Jiang, W.; Brown, P.D.; Braunstein, S.; Sneed, P.; Wattson, D.A.; Shih, H.A.; Bangdiwala, A.; Shanley, R.; Lockney, N.A.; et al. Estimating Survival in Melanoma Patients with Brain Metastases: An Update of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA). Int. J. Radiat. Oncol. Biol. Phys. 2017, 99, 812–816. [Google Scholar] [CrossRef]
- Sperduto, P.W.; Deegan, B.J.; Li, J.; Jethwa, K.R.; Brown, P.D.; Lockney, N.; Beal, K.; Rana, N.G.; Attia, A.; Tseng, C.-L.; et al. Estimating survival for renal cell carcinoma patients with brain metastases: An update of the Renal Graded Prognostic Assessment tool. Neuro-Oncology 2018, 20, 1652–1660. [Google Scholar] [CrossRef]
- Sperduto, P.W.; Fang, P.; Li, J.; Breen, W.; Brown, P.D.; Cagney, D.; Aizer, A.; Yu, J.B.; Chiang, V.; Jain, S.; et al. Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA). Clin. Transl. Radiat. Oncol. 2019, 18, 39–45. [Google Scholar] [CrossRef] [PubMed]
- Sperduto, P.W.; Mesko, S.; Li, J.; Cagney, D.; Aizer, A.; Lin, N.U.; Nesbit, E.; Kruser, T.J.; Chan, J.; Braunstein, S.; et al. Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases from 1985 to Today. Int. J. Radiat. Oncol. Biol. Phys. 2020, 107, 334–343. [Google Scholar] [CrossRef]
- Sperduto, P.W.; De, B.; Li, J.; Carpenter, D.; Kirkpatrick, J.; Milligan, M.; Shih, H.A.; Kutuk, T.; Kotecha, R.; Higaki, H.; et al. Graded Prognostic Assessment (GPA) for Patients with Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors. Int. J. Radiat. Oncol. 2022, 114, 60–74. [Google Scholar] [CrossRef]
- El Ali, Z.; Rottey, S.; Barthelemy, P.; Kotecki, N.; Van Paemel, R.; Devrient, D.; Awada, A.; Gil, T.; Pannier, D.; Ryckewaert, T.; et al. Brain Metastasis and Renal Cell Carcinoma: Prognostic Scores Assessment in the Era of Targeted Therapies. Anticancer. Res. 2019, 39, 2993–3002. [Google Scholar] [CrossRef]
- Gaspar, L.; Scott, C.; Rotman, M.; Asbell, S.; Phillips, T.; Wasserman, T.; McKenna, W.G.; Byhardt, R. Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials. Int. J. Radiat. Oncol. Biol. Phys. 1997, 37, 745–751. [Google Scholar] [CrossRef]
- Key Statistics About Kidney Cancer. Available online: https://www.cancer.org/cancer/types/kidney-cancer/about/key-statistics.html (accessed on 26 June 2023).
- Key Statistics About Lung Cancer. Available online: https://www.cancer.org/cancer/types/lung-cancer/about/key-statistics.html (accessed on 26 June 2023).
- Key Statistics About Breast Cancer. Available online: https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html (accessed on 26 June 2023).
- Barnholtz-Sloan, J.S.; Yu, C.; Sloan, A.E.; Vengoechea, J.; Wang, M.; Dignam, J.J.; Vogelbaum, M.A.; Sperduto, P.W.; Mehta, M.P.; Machtay, M.; et al. A nomogram for individualized estimation of survival among patients with brain metastasis. Neuro-Oncology 2012, 14, 910–918. [Google Scholar] [CrossRef] [PubMed]
- Thon, N.; Kreth, F.-W.; Tonn, J.-C. Chapter 8—The role of surgery for brain metastases from solid tumors. Handb. Clin. Neurol. 2018, 149, 113–121. [Google Scholar] [CrossRef]
- Nieblas-Bedolla, E.; Nayyar, N.; Singh, M.; Sullivan, R.J.; Brastianos, P.K. Emerging Immunotherapies in the Treatment of Brain Metastases. Oncologist 2020, 26, 231–241. [Google Scholar] [CrossRef] [PubMed]
- Hügel, M.; Stöhr, J.; Kuhnt, T.; Nägler, F.; Papsdorf, K.; Klagges, S.; Hambsch, P.; Güresir, E.; Nicolay, N.H.; Seidel, C. Long-term survival in patients with brain metastases—Clinical characterization of a rare scenario. Strahlenther. Onkol. 2023, 200, 335–345. [Google Scholar] [CrossRef] [PubMed]
- Moraes, F.Y.; Taunk, N.K.; Marta, G.N.; Suh, J.H.; Yamada, Y. The Rationale for Targeted Therapies and Stereotactic Radiosurgery in the Treatment of Brain Metastases. Oncologist 2016, 21, 244–251. [Google Scholar] [CrossRef]
- Rice, S.R.; Bentzen, S.M.; Hanna, A.; Choi, E.; Boggs, D.H.; Kwok, Y.; Hyder, J.; Feigenberg, S.J.; Regine, W.F.; Woodworth, G.F.; et al. Prognostic models for patients with brain metastases after stereotactic radiosurgery with or without whole brain radiotherapy: A validation study. J. Neuro-Oncol. 2018, 140, 341–349. [Google Scholar] [CrossRef]
- Marchand-Crety, C.; Riverain, J.; Drouet, Y.; Felici, F.; Jeandidier, C.; Thariat, J.; Servagi-Vernat, S. A new model outperforming RPA and DS-GPA scores for individualized survival prediction of patients following whole brain irradiation for brain metastasis. Cancer Radiother. 2021, 25, 447–456. [Google Scholar] [CrossRef] [PubMed]
- Yamamoto, M.; Aiyama, H.; Koiso, T.; Watanabe, S.; Kawabe, T.; Sato, Y.; Higuchi, Y.; Kasuya, H.; Barfod, B.E. Applicability and limitations of a recently-proposed prognostic grading metric, initial brain metastasis velocity, for brain metastasis patients undergoing stereotactic radiosurgery. J. Neuro-Oncol. 2019, 143, 613–621. [Google Scholar] [CrossRef] [PubMed]
- Soria, J.-C.; Ohe, Y.; Vansteenkiste, J.; Reungwetwattana, T.; Chewaskulyong, B.; Lee, K.H.; Dechaphunkul, A.; Imamura, F.; Nogami, N.; Kurata, T.; et al. Osimertinib in Untreated EGFR-Mutated Advanced Non–Small-Cell Lung Cancer. N. Engl. J. Med. 2018, 378, 113–125. [Google Scholar] [CrossRef] [PubMed]
- Wolf, A.; Donahue, B.; Silverman, J.S.; Chachoua, A.; Lee, J.K.; Kondziolka, D. Stereotactic radiosurgery for focal leptomeningeal disease in patients with brain metastases. J. Neuro-Oncol. 2017, 134, 139–143. [Google Scholar] [CrossRef] [PubMed]
- Venur, V.A.; Ahluwalia, M.S. Targeted Therapy in Brain Metastases: Ready for Primetime? Am. Soc. Clin. Oncol. Educ. Book 2016, 36, e123–e130. [Google Scholar] [CrossRef]
- Amin, S.; Baine, M.J.; Meza, J.L.; Lin, C. Association of Immunotherapy with Survival Among Patients with Brain Metastases Whose Cancer Was Managed with Definitive Surgery of the Primary Tumor. JAMA Netw. Open 2020, 3, e2015444. [Google Scholar] [CrossRef] [PubMed]
- Di Lorenzo, R.; Ahluwalia, M.S. Targeted therapy of brain metastases: Latest evidence and clinical implications. Ther. Adv. Med Oncol. 2017, 9, 781–796. [Google Scholar] [CrossRef]
- Rubino, S.; Oliver, D.E.; Tran, N.D.; Vogelbaum, M.A.; Forsyth, P.A.; Yu, H.-H.M.; Ahmed, K.; Etame, A.B. Improving Brain Metastases Outcomes Through Therapeutic Synergy Between Stereotactic Radiosurgery and Targeted Cancer Therapies. Front. Oncol. 2022, 12, 854402. [Google Scholar] [CrossRef] [PubMed]
- Sperduto, P.W.; Yang, T.J.; Beal, K.; Pan, H.; Brown, P.D.; Bangdiwala, A.; Shanley, R.; Yeh, N.; Gaspar, L.E.; Braunstein, S.; et al. Estimating Survival in Patients with Lung Cancer and Brain Metastases. JAMA Oncol. 2017, 3, 827–831. [Google Scholar] [CrossRef] [PubMed]
RTOG RPA § | I | II | III | |||||
---|---|---|---|---|---|---|---|---|
Age at diagnosis of first BM | <65 | all | all | |||||
and | and | and | ||||||
KPS at diagnosis of first BM | ≥70 | ≥70 | <70 | |||||
and | and | and | ||||||
Other extracranial metastases | No | No/Yes | No/Yes | |||||
DS-GPA # | ||||||||
Breast carcinoma | 0 | 0.5 | 1 | 1.5 | 2 | |||
Age | ≥60 | <60 | ||||||
KPS | ≤60 | 70–80 | 90–100 | |||||
Number of brain metastatic lesions | >1 | 1 | ||||||
Subtype | ER− PR− HER2− | ER+ PR+ HER2− | HER2+ | |||||
Gastrointestinal carcinoma | 0 | 0.5 | 1 | 1.5 | 2 | |||
Age | ≥60 | <60 | ||||||
KPS | <80 | 80 | 90–100 | |||||
Extracranial metastases present | Present | Absent | ||||||
Number of brain metastatic lesions | >3 | 2–3 | 1 | |||||
RCC | 0 | 0.5 | 1 | 1.5 | 2 | |||
KPS | <80 | 80 | 90–100 | |||||
Extracranial metastases present | Present | Absent | ||||||
Number of brain metastatic lesions | >3 | 2–3 | 1 | |||||
Hemoglobin (g/dL) | ≤11 | 11.1–12.5 | >12.5 | |||||
Melanoma | 0 | 0.5 | 1 | 1.5 | 2 | |||
Age | ≥70 | <70 | ||||||
KPS | ≤70 | 80 | 90–100 | |||||
Extracranial metastases present | Present | Absent | ||||||
Number of brain metastatic lesions | >4 | 2–4 | 1 | |||||
BRAF mutation | Absent | Present | ||||||
NSCLC—adenocarcinoma | 0 | 0.5 | 1 | 1.5 | 2 | |||
Age | ≥70 | <70 | ||||||
KPS | ≤70 | 80 | 90–100 | |||||
Extracranial metastases present | Present | Absent | ||||||
Number of brain metastatic lesions | ≥5 | 1–4 | ||||||
EGFR and ALK mutation | Absent | Present | ||||||
PD-L1 status (%) | <1 | ≥1 | ||||||
NSCLC—non-adenocarcinoma | 0 | 0.5 | 1 | 1.5 | 2 | |||
Age | ≥70 | <70 | ||||||
KPS | ≤60 | 70 | 80 | 90–100 | ||||
Extracranial metastases present | Present | Absent | ||||||
Number of brain metastatic lesions | ≥5 | 1–4 | ||||||
DS-GPA # | ||||||||
SCLC | 0 | 0.5 | 1 | 1.5 | 2 | |||
Age | ≥75 | <75 | ||||||
KPS | ≤60 | 70 | 80 | 90 | 100 | |||
Extracranial metastases present | Present | Absent | ||||||
Number of brain metastatic lesions | ≥8 | 4–7 | 1–3 | |||||
CERENAL # | 0 | 1 | ||||||
Age at diagnosis of first BM * | ≤60 years | >60 years | ||||||
KPS at diagnosis of first BM | >70 | ≤70 | ||||||
Other extracranial metastases | No | Yes | ||||||
PD at diagnosis of first BM | No | Yes | ||||||
Number of brain metastatic lesions * | 1–2 | ≥3 | ||||||
Received NS, SRS or boost to WBRT * | Yes | No |
A. With each other brain metastasis prognostic score | ||||||||
CERENAL | 0–3 | 4–6 | p | |||||
RTOG RPA | I/II | 72 | 78 | <0.0001 | ||||
III | 6 | 44 | ||||||
ρ = 0.459; p < 0.0001 | ||||||||
CERENAL | 0–3 | 4–6 | p | |||||
DS-GPA | 0.0–2.0 | 39 | 111 | <0.0001 | ||||
2.5–4.0 | 39 | 11 | ||||||
ρ = −0.681; p < 0.0001 | ||||||||
RTOG RPA | I/II | III | p | |||||
DS-GPA | 0.0–2.0 | 102 | 48 | <0.0001 | ||||
2.5–4.0 | 48 | 2 | ||||||
ρ = −0.480; p < 0.0001 | ||||||||
B. With administered primary local therapy for BMs | ||||||||
Primary local therapy | No | WBRT 20 Gy | WBRT 30 Gy | WBRT 30 Gy + NS/SRS/boost | SRS | p | ||
RTOG RPA | I/II | 2 | 78 | 8 | 58 | 4 | <0.0001 | |
III | 5 | 39 | 2 | 4 | 0 | |||
ρ = −0.348; p < 0.0001 | ||||||||
DS-GPA | 0.0–2.0 | 6 | 101 | 6 | 35 | 2 | 0.0002 | |
2.5–4.0 | 1 | 16 | 4 | 27 | 2 | |||
ρ = 0.437; p < 0.0001 | ||||||||
CERENAL | 0–3 | 3 | 14 | 4 | 54 | 3 | <0.0001 | |
4–6 | 4 | 103 | 6 | 8 | 1 | |||
ρ = −0.638; p < 0.0001 | ||||||||
C. With subsequent systemic therapy | ||||||||
Subsequent systemic therapy | No | Yes | p | |||||
RTOG RPA | I/II | 71 | 79 | 0.0025 | ||||
III | 36 | 14 | ||||||
ρ = −0.143; p = 0.0440 | ||||||||
DS-GPA | 0.0–2.0 | 80 | 70 | 0.9349 | ||||
2.5–4.0 | 27 | 23 | ||||||
ρ = 0.056; p = 0.4338 | ||||||||
CERENAL | 0–3 | 39 | 39 | 0.4286 | ||||
4–6 | 68 | 54 | ||||||
ρ = −0.023; p = 0.7519 |
Parameter | N | Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|---|---|
Median OS (95% CI) | HR (95% CI) | p | HR (95% CI) | p | ||||
A. ITT | Subsequent θ | Yes | 93 | 10.4 (8.9–13.1) | 1 | |||
No | 107 | 3.9 (2.9–4.5) | 2.10 (1.55–2.86) | <0.0001 | ||||
RTOG RPA | I/II | 150 | 8.1 (6.4–9.8) | 1 | 1 | |||
III | 50 | 2.9 (2.0–4.3) | 2.19 (1.47–3.27) | 0.0001 | 1.46 (1.03–2.07) | 0.0330 | ||
DS-GPA | 0.0–2.0 | 150 | 5.7 (4.3–6.9) | 1 | 1 | |||
2.5–4.0 | 50 | 9.4 (6.4–18.5) | 0.56 (0.41–0.77) | 0.0003 | 0.80 (0.53–1.21) | 0.2934 | ||
CERENAL | 0–3 | 78 | 10.9 (7.3–16.6) | 1 | 1 | |||
4–6 | 122 | 4.5 (3.5–5.9) | 2.28 (1.69–3.09) | <0.0001 | 2.08 (1.50–2.88) | <0.0001 | ||
B. No θ | RTOG RPA | I/II | 71 | 4.5 (3.9–5.8) | 1 | 1 | ||
III | 36 | 2.1 (1.5–2.9) | 1.67 (1.05–2.65) | 0.0319 | 1.20 (0.77–1.88) | 0.4209 | ||
DS-GPA | 0.0–2.0 | 80 | 3.0 (2.5–4.0) | 1 | 1 | |||
2.5–4.0 | 27 | 5.9 (4.1–15.8) | 0.49 (0.32–0.75) | 0.0010 | 0.75 (0.41–1.37) | 0.3511 | ||
CERENAL | 0–3 | 39 | 5.8 (4.5–14.1) | 1 | 1 | |||
4–6 | 68 | 2.6 (2.3–3.0) | 2.49 (1.64–3.77) | <0.0001 | 2.51 (1.62–3.89) | <0.0001 | ||
C. θ | RTOG RPA | I/II | 79 | 11.6 (9.4–13.3) | 1 | 1 | ||
III | 14 | 5.6 (3.5–8.9) | 4.80 (2.03–11.3) | 0.0003 | 1.97 (1.06–3.66) | 0.0330 | ||
DS-GPA | 0.0–2.0 | 70 | 9.9 (7.8–12.9) | 1 | 1 | |||
2.5–4.0 | 23 | 16.6 (8.8–31.9) | 0.57 (0.36–0.90) | 0.0148 | 0.79 (0.44–1.41) | 0.4236 | ||
CERENAL | 0–3 | 39 | 14.4 (9.4–29.2) | 1 | 1 | |||
4–6 | 54 | 8.9 (6.5–10.9) | 2.38 (1.52–3.74) | 0.0002 | 2.06 (1.27–3.34) | 0.0032 |
Parameter | N | Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|---|---|
Median DSS (95% CI) | HR (95% CI) | p | HR (95% CI) | p | ||||
A. ITT | Subsequent θ | Yes | 88 | 10.9 (9.1–13.1) | 1 | |||
No | 104 | 3.9 (2.9–4.5) | 2.16 (1.58–2.97) | <0.0001 | ||||
RTOG RPA | I/II | 145 | 8.1 (6.4–10.4) | 1 | 1 | |||
III | 47 | 2.9 (2.0–4.5) | 2.09 (1.38–3.16) | 0.0005 | 1.39 (0.97–2.00) | 0.0732 | ||
DS-GPA | 0.0–2.0 | 143 | 5.8 (4.5–7.1) | 1 | 1 | |||
2.5–4.0 | 49 | 9.4 (6.4–18.7) | 0.55 (0.40–0.76) | 0.0003 | 0.80 (0.52–1.23) | 0.3093 | ||
CERENAL | 0–3 | 76 | 10.7 (7.3–16.6) | 1 | 1 | |||
4–6 | 116 | 4.5 (3.5–6.1) | 2.32 (1.70–3.16) | <0.0001 | 2.32 (1.69–3.20) | <0.0001 | ||
B. No θ | RTOG RPA | I/II | 69 | 4.5 (3.5–5.8) | 1 | 1 | ||
III | 35 | 2.3 (1.5–2.9) | 1.58 (0.98–2.54) | 0.0589 | 1.15 (0.73–1.81) | 0.5435 | ||
DS-GPA | 0.0–2.0 | 77 | 3.0 (2.5–3.9) | 1 | 1 | |||
2.5–4.0 | 27 | 5.9 (4.1–15.8) | 0.48 (0.31–0.73) | 0.0008 | 0.74 (0.39–1.39) | 0.3493 | ||
CERENAL | 0–3 | 37 | 5.8 (4.5–15.8) | 1 | 1 | |||
4–6 | 67 | 2.6 (2.3–3.5) | 2.50 (1.64–3.82) | <0.0001 | 2.56 (1.63–4.02) | <0.0001 | ||
C. θ | RTOG RPA | I/II | 76 | 11.6 (9.4–13.5) | 1 | 1 | ||
III | 12 | 6.4 (3.5–11.5) | 4.34 (1.75–10.8) | 0.0015 | 1.83 (0.94–3.56) | 0.0744 | ||
DS-GPA | 0.0–2.0 | 66 | 10.4 (8.4–13.1) | 1 | 1 | |||
2.5–4.0 | 22 | 16.6 (7.1–37.5) | 0.55 (0.35–0.89) | 0.0140 | 0.74 (0.40–1.36) | 0.3306 | ||
CERENAL | 0–3 | 39 | 14.4 (9.4–29.2) | 1 | 1 | |||
4–6 | 49 | 9.4 (6.9–11.6) | 2.31 (1.45–3.68) | 0.0004 | 2.26 (1.42–3.60) | 0.0006 |
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Vermassen, T.; Van Parijs, C.; De Keukeleire, S.; Vandecasteele, K.; Rottey, S. Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up. Curr. Oncol. 2025, 32, 74. https://doi.org/10.3390/curroncol32020074
Vermassen T, Van Parijs C, De Keukeleire S, Vandecasteele K, Rottey S. Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up. Current Oncology. 2025; 32(2):74. https://doi.org/10.3390/curroncol32020074
Chicago/Turabian StyleVermassen, Tijl, Charlotte Van Parijs, Stijn De Keukeleire, Katrien Vandecasteele, and Sylvie Rottey. 2025. "Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up" Current Oncology 32, no. 2: 74. https://doi.org/10.3390/curroncol32020074
APA StyleVermassen, T., Van Parijs, C., De Keukeleire, S., Vandecasteele, K., & Rottey, S. (2025). Prognostication of Brain-Metastasized Patients Receiving Subsequent Systemic Therapy: A Single-Center Long-Term Follow-Up. Current Oncology, 32(2), 74. https://doi.org/10.3390/curroncol32020074