Prognostic scores in brain metastases from breast cancer

<p>Abstract</p> <p>Background</p> <p>Prognostic scores might be useful tools both in clinical practice and clinical trials, where they can be used as stratification parameter. The available scores for patients with brain metastases have never been tested specifically in...

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Main Authors: Astner Sabrina T, Marienhagen Kirsten, Nieder Carsten, Molls Michael
Format: Article
Language:English
Published: BMC 2009-04-01
Series:BMC Cancer
Online Access:http://www.biomedcentral.com/1471-2407/9/105
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author Astner Sabrina T
Marienhagen Kirsten
Nieder Carsten
Molls Michael
author_facet Astner Sabrina T
Marienhagen Kirsten
Nieder Carsten
Molls Michael
author_sort Astner Sabrina T
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Prognostic scores might be useful tools both in clinical practice and clinical trials, where they can be used as stratification parameter. The available scores for patients with brain metastases have never been tested specifically in patients with primary breast cancer. It is therefore unknown which score is most appropriate for these patients.</p> <p>Methods</p> <p>Five previously published prognostic scores were evaluated in a group of 83 patients with brain metastases from breast cancer. All patients had been treated with whole-brain radiotherapy with or without radiosurgery or surgical resection. In addition, it was tested whether the parameters that form the basis of these scores actually have a prognostic impact in this biologically distinct group of brain metastases patients.</p> <p>Results</p> <p>The scores that performed best were the recursive partitioning analysis (RPA) classes and the score index for radiosurgery (SIR). However, disagreement between the parameters that form the basis of these scores and those that determine survival in the present group of patients and many reported data from the literature on brain metastases from breast cancer was found. With the four statistically significant prognostic factors identified here, a 3-tiered score can be created that performs slightly better than RPA and SIR. In addition, a 4-tiered score is also possible, which performs better than the three previous 4-tiered scores, incl. graded prognostic assessment (GPA) score and basic score for brain metastases (BSBM).</p> <p>Conclusion</p> <p>A variety of prognostic models describe the survival of patients with brain metastases from breast cancer to a more or less satisfactory degree. However, the standard brain metastases scores might not fully appreciate the unique biology and time course of this disease, e.g., compared to lung cancer. It appears possible that inclusion of emerging prognostic factors will improve the results and allow for development and validation of a consensus score for broad clinical application. The model that is based on the authors own patient group, which is not large enough to fully evaluate a large number of potential prognostic factors, is meant to illustrate this point rather than to provide the definitive score.</p>
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spelling doaj.art-4c9f7aae8270453abbc5e7f6194644bc2022-12-21T23:30:20ZengBMCBMC Cancer1471-24072009-04-019110510.1186/1471-2407-9-105Prognostic scores in brain metastases from breast cancerAstner Sabrina TMarienhagen KirstenNieder CarstenMolls Michael<p>Abstract</p> <p>Background</p> <p>Prognostic scores might be useful tools both in clinical practice and clinical trials, where they can be used as stratification parameter. The available scores for patients with brain metastases have never been tested specifically in patients with primary breast cancer. It is therefore unknown which score is most appropriate for these patients.</p> <p>Methods</p> <p>Five previously published prognostic scores were evaluated in a group of 83 patients with brain metastases from breast cancer. All patients had been treated with whole-brain radiotherapy with or without radiosurgery or surgical resection. In addition, it was tested whether the parameters that form the basis of these scores actually have a prognostic impact in this biologically distinct group of brain metastases patients.</p> <p>Results</p> <p>The scores that performed best were the recursive partitioning analysis (RPA) classes and the score index for radiosurgery (SIR). However, disagreement between the parameters that form the basis of these scores and those that determine survival in the present group of patients and many reported data from the literature on brain metastases from breast cancer was found. With the four statistically significant prognostic factors identified here, a 3-tiered score can be created that performs slightly better than RPA and SIR. In addition, a 4-tiered score is also possible, which performs better than the three previous 4-tiered scores, incl. graded prognostic assessment (GPA) score and basic score for brain metastases (BSBM).</p> <p>Conclusion</p> <p>A variety of prognostic models describe the survival of patients with brain metastases from breast cancer to a more or less satisfactory degree. However, the standard brain metastases scores might not fully appreciate the unique biology and time course of this disease, e.g., compared to lung cancer. It appears possible that inclusion of emerging prognostic factors will improve the results and allow for development and validation of a consensus score for broad clinical application. The model that is based on the authors own patient group, which is not large enough to fully evaluate a large number of potential prognostic factors, is meant to illustrate this point rather than to provide the definitive score.</p>http://www.biomedcentral.com/1471-2407/9/105
spellingShingle Astner Sabrina T
Marienhagen Kirsten
Nieder Carsten
Molls Michael
Prognostic scores in brain metastases from breast cancer
BMC Cancer
title Prognostic scores in brain metastases from breast cancer
title_full Prognostic scores in brain metastases from breast cancer
title_fullStr Prognostic scores in brain metastases from breast cancer
title_full_unstemmed Prognostic scores in brain metastases from breast cancer
title_short Prognostic scores in brain metastases from breast cancer
title_sort prognostic scores in brain metastases from breast cancer
url http://www.biomedcentral.com/1471-2407/9/105
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AT marienhagenkirsten prognosticscoresinbrainmetastasesfrombreastcancer
AT niedercarsten prognosticscoresinbrainmetastasesfrombreastcancer
AT mollsmichael prognosticscoresinbrainmetastasesfrombreastcancer