TABLE 1.
Comparison of Eight Prognostic Point Scores for Whole Brain Radiation Therapy
| Brain Metastases | Class & Point Score (median survival in months) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Name(# studied) | PS | Age | EM | CP | SR | # | Volume | When Found | I | II | III | IV |
| RPA (1,200) | KPS ≥ 70 | < 65 | Yes/No | Yes/No | All favorable | Other | KPS < 70 | |||||
| (4–9) | (3) | (2) | ||||||||||
| Rotterdam (1,292) | ECOG 0–1 vs 2–3 | Limited vs extensive | Good to little response | ECOG 0–1, limited EM/CP, good SR | Other | ECOG 2–3 & limited EM / CP or extensive EM / CP & little SR | ||||||
| SIR (65) | KPS 80–100 = 2 pts; 60–70 = 1 pt | ≤ 50 2 pts; 51–59 = 1 pt | No systemic disease or CR = 2 pts; PR or stable disease = 1 pt | 1 = 2 pts, 2 = 1 pt | Largest < 5 mL = 2 pts; 5–13 mL = 1 pt (size unknown) | 8–10 | 4–7 | 1–3; don't know size of Nancy's brain tumors, so score could be 4, then class II | ||||
| (6.3) | (3.3) | (1.6) | ||||||||||
| BSBM | KPS | None = | Yes = | 3 | 2 | 1 | 0 | |||||
| (110) | 80–100 = | 1 pt | 1 pt | |||||||||
| 1 pt | (9) | (4) | (3) | (2) | ||||||||
| GPA (5 trials) | KPS 90–100 | < 50 1 pt; | None = | 1 = 1 pt | 3.5–4 | 3 | 1.5–2.5 | 0–1 | ||||
| 1 pt; 70–80 | 50–59 | 1 pt | (9.5–21.7) | (4.3–17.5) | (2.5–5.9) | (1.6–3.7) | ||||||
| .5 pt | .5 pt | |||||||||||
| Rades (1,085) | KPS ≥ 70 = | ≤ 60 4 pts, | None = 5 pts, | > 8 mos = 4, | 17–18 | 14–16 | 11–13; | 9–10 | ||||
| 5 pts, <70 = 1 pt | >60 3 pts | else 2 pts | ≤ 8 mos = 3 | (5.0) | (2.5) | (1.6) | (1.3) | |||||
| Chao (157) | KPS 70–80 = | Bone = 1 pt; | ≤ 12 mos = | 0–1 | 2 | 3 | > 3 | |||||
| 1 pt; ≤ 60 = 2 pts | liver = 2 pts | 1 pt | (6.1) | (3.9) | (2.8) | (1.9) | ||||||
| Golden (169) | <65 = 1 pt | None = 1 pt | ≤ 3 1 pt | 3 | 2 | 1 | 0 | |||||
| (3.5) | (2.3) | (2.1) | (1.6) | |||||||||
Notes: Nancy's scores are in boldface. Empty field means not used in scoring. RPA = recursive partitioning analysis, SIR = score index for radiosurgery, KPS = Karnofsky performance score, RTOG = Radiation Therapy Oncology Group, BSBM = basic score for brain metastases, GPA = graded prognostic assessment, ECOG = Eastern Cooperative Oncology Group, CR = complete remission, PR = partial remission, PS = performance status, EM = extracranial metastases, CP = controlled primary tumor, SR = steroid treatment response, pts = points, mos = months, mL = milliliter.
Source: Adapted from Carsten Nieder, Roy M. Bremnes, and Nicolaus H. Andratschke. 2009. Prognostic Scores in Patients with Brain Metastases from Non-Small-Cell Lung Cancer. Journal of Thoracic Oncology 4(11):1337–41. Used with permission.