Použití prognostických indexů pro pacienty s mozkovými metastázami v denní radioterapeutické praxi – je jejich složitý výpočet ještě stále problém?

KAZDA, Tomáš, Adéla KUKLOVÁ, Petr POSPÍŠIL, Petr BURKOŇ, Marek SLÁVIK, Ludmila HYNKOVÁ, T. PROCHAZKA, M. VRZAL, M. STAVIK, Pavel ŠLAMPA and Radim JANČÁLEK. Použití prognostických indexů pro pacienty s mozkovými metastázami v denní radioterapeutické praxi – je jejich složitý výpočet ještě stále problém? (Utilization of Prognostic Indexes for Patients with Brain Metastases in Daily Radiotherapy Routine – is the Complexity and Intricacy Still an Issue?). Klinická onkologie. Praha: Česká lékařská společnost J.E. Purkyně, 2015, vol. 28, No 5, p. 352-358. ISSN 0862-495X.

Basic information

• Original name: Použití prognostických indexů pro pacienty s mozkovými metastázami v denní radioterapeutické praxi – je jejich složitý výpočet ještě stále problém?
• Name (in English): Utilization of Prognostic Indexes for Patients with Brain Metastases in Daily Radiotherapy Routine – is the Complexity and Intricacy Still an Issue?
• Authors: KAZDA, Tomáš (203 Czech Republic, guarantor, belonging to the institution), Adéla KUKLOVÁ (203 Czech Republic, belonging to the institution), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), Petr BURKOŇ (203 Czech Republic, belonging to the institution), Marek SLÁVIK (203 Czech Republic, belonging to the institution), Ludmila HYNKOVÁ (203 Czech Republic, belonging to the institution), T. PROCHAZKA (203 Czech Republic), M. VRZAL (203 Czech Republic), M. STAVIK (203 Czech Republic), Pavel ŠLAMPA (203 Czech Republic, belonging to the institution) and Radim JANČÁLEK (203 Czech Republic, belonging to the institution).
• Edition: Klinická onkologie, Praha, Česká lékařská společnost J.E. Purkyně, 2015, 0862-495X.

Other information

• Original language: Czech
• Type of outcome: Article in a journal
• Field of Study: 30200 3.2 Clinical medicine
• Country of publisher: Czech Republic
• Confidentiality degree: is not subject to a state or trade secret
• RIV identification code: RIV/00216224:14110/15:00085374
• Organization unit: Faculty of Medicine
• Keywords in English: prognosis; nomograms; cranial irradiation; RPA; GPA; WBRT- 30
• Tags: EL OK
• Tags: International impact, Reviewed

Abstract

Východiska: Existuje několik prognostických indexů pro pacienty s mozkovými metastázami, které mohou pomoci při rozhodování o nejlepší léčbě zahrnující mimo jiné i paliativní radioterapii. Jejich výpočet ale bývá poměrně složitý. Připravili jsme praktickou tabulku pro jejich jednoduchou kalkulaci, pomocí které jsme retrospektivně vyhodnotili vybrané prognostické indexy (RPA, GPA a WBRT- 30) u pacientů podstupujících radioterapii na našem pracovišti. Soubor pacientů a metody: Byla vyhodnocena konsekutivní série pacientů ozařovaných v roce 2011 pro nově diagnostikované mozkové metastázy a jejich přežití bylo porovnáno s odhadovanou prognózou dle jednotlivých prognostických indexů a s použitou ozařovací technikou.

Abstract (in English)

Background: Many prognostic indexes are available for patients with brain metastases in order to estimate remaining lifetime before selection of appropriate treatment including palliative radiotherapy. Their routine utilization is often deprecated for their complexity. We developed a practical tool based on widely available spreadsheet editors for facilitation of daily clinical use of selected indexes (RPA, GPA and WBRT- 30) and evaluated its usage for retrospective single institutional survival analysis of patients irradiated for brain metastases. Patients and Methods: Spreadsheet platform was prepared and adjusted for automatic calculation of selected prognostic indexes after input of the relevant parameters. The consecutive series of newly diag - nosed patients referred during 2011 to the palliative brain radiotherapy were analyzed, and real calculated survival parameters of individual subgroups of RPA, GPA and WBRT- 30 were compared with estimated ones. Correlation of radiotherapy technique and estimated survival at the time of treatment indication was evaluated. Results: Total of 121 patients (61% with multiple metastases) were irradiated with the majority undergoing whole brain radiotherapy. Median overall survival from the time of radiotherapy indication was 3.13 months. Non- balanced distribution into individual scoring systems subgroups was observed with 8 (7%), 89 (73%) and 24 (20%) patients assigned to RPA 1, 2 and 3 subgroup, 3 (3%), 9 (7%), 57 (47%) and 52 (43%) patients assigned to GPA 3.5– 4, GPA 3.0, GPA 1.5– 2.5 and GPA 0– 1.0 subgroup and 10 (8%), 88 (73%) and 23 (19%) patients assigned to WBRT- 30 subgroup D, B and A. Entire di erences in overall survival between subgroups are signi cant among all three scoring systems. Conclusion: Routine calculation of available prognostic indexes is useful in decision making regarding the best radiotherapy of brain metastases, and their calculation is greatly facilitated by properly prepared widely available spreadsheet tools.