Histological Impact on the Survival of Lung Cancer Patients with Brain Metastases Treated by Whole Brain Radiation Therapy: Analysis of Patients with Poor Prognosis based on the Diagnosis-specific Graded Prognostic Assessment Score

2017 ◽  
Vol 99 (2) ◽  
pp. E465
Author(s):  
N. Imano ◽  
K. Wadasaki ◽  
I. Nishibuchi ◽  
Y. Takeuchi ◽  
I. Takahashi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Brain Metastases ◽  
Poor Prognosis ◽  
Lung Cancer Patients ◽  
Prognostic Assessment ◽  
Whole Brain Radiation ◽  
Graded Prognostic Assessment ◽  
Brain Radiation ◽  
Patients With Poor Prognosis

Survival and Neurologic Outcomes in a Randomized Trial of Motexafin Gadolinium and Whole-Brain Radiation Therapy in Brain Metastases

2003 ◽  
Vol 21 (13) ◽  
pp. 2529-2536 ◽  
Author(s):  
Minesh P. Mehta ◽  
Patrick Rodrigus ◽  
C.H.J. Terhaard ◽  
Aroor Rao ◽  
John Suh ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Brain Metastases ◽  
Randomized Trial ◽  
Cancer Patients ◽  
Treatment Benefit ◽  
Motexafin Gadolinium ◽  
Lung Cancer Patients ◽  
Whole Brain Radiation ◽  
Brain Radiation

Purpose: This phase III randomized trial evaluated survival as well as neurologic and neurocognitive function in patients with brain metastases from solid tumors receiving whole-brain radiation therapy (WBRT) with or without motexafin gadolinium (MGd). Patients and Methods: Patients were randomly assigned to 30 Gy of WBRT ± 5 mg/kg/d MGd. Survival and time to neurologic progression determined by a blinded events review committee (ERC) were coprimary end points. Standardized investigator neurologic assessment and neurocognitive testing were evaluated. Results: Four hundred one (251 non–small-cell lung cancer) patients were enrolled. There was no significant difference by treatment arm in survival (median, 5.2 months for MGd v 4.9 months for WBRT; P = .48) or time to neurologic progression (median, 9.5 months for MGd v 8.3 months for WBRT; P = .95). Treatment with MGd improved time to neurologic progression in patients with lung cancer (median, not reached for MGd v 7.4 months for WBRT; P = .048, unadjusted). By investigator, MGd improved time to neurologic progression in all patients (median, 4.3 months for MGd v 3.8 months for WBRT; P = .018) and in lung cancer patients (median, 5.5 months for MGd v 3.7 months for WBRT; P = .025). MGd improved neurocognitive function in lung cancer patients. Conclusion: The overall results did not demonstrate significant differences by treatment arm for survival and ERC time to neurologic progression. Investigator neurologic assessments demonstrated an MGd treatment benefit in all patients. In lung cancer patients, ERC- and investigator-determined time to neurologic progression demonstrated an MGd treatment benefit. MGd may improve time to neurologic and neurocognitive progression in lung cancer.

scholarly journals MANFAAT SKORING PROGNOSTIK DALAM PENENTUAN TATA LAKSANA KASUS METASTASIS OTAK

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Yunni Diansari
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Recursive Partitioning ◽  
Recursive Partitioning Analysis ◽  
Prognostic Scores ◽  
Prognostic Assessment ◽  
Whole Brain Radiation ◽  
Graded Prognostic Assessment ◽  
Brain Radiation ◽  
Score Index

 CLINICAL UTILITY OF PROGNOSTIC SCORES TO GUIDE THE MANAGEMENT OF BRAIN METASTASESABSTRACTMetastatic brain tumors are the most common intracranial neoplasms in adults and associated with significant morbidity and mortality. The current therapeutic options include surgery, whole brain radiation therapy (WBRT), stereotactic radiation (SRS), systemic therapy and symptom management only. The goals of brain metastasis management are giving longer survival, if possible the improvement in neurologic deficit and a better quality of life. Prognostic scores, a useful tool for BM patients, as an estimation of a patient’s prognosis can guide the tailored treatment for these patients. A more aggressive approaches is recommended in patients with good performance state with and controlled systemic disease. While palliative management is focused to patients on terminal state or with other comorbid disease. A number of prognostic scoring systems for BM patients have been proposed are Recursive Partitioning Analysis (RPA), the Score Index for Radiosurgery (SIR), the Basic Score for Brain Metastases (BSBM) and the Graded Prognostic Assessment (GPA). Recursive Partitioning Analysis and GPA are able to be implemented in brain metastatic patient in Indonesia.Keyword: Brain metastatic, prognostic scores, survival rateABSTRAKTumor otak metastasis merupakan tumor intrakranial yang paling sering dijumpai dan menyebabkan morbiditas serta mortalitas yang bermakna. Pilihan tata laksana terdiri dari tindakan bedah, whole brain radiation therapy (WBRT), sterotactic radiosurgery (SRS), terapi sistemik atau tata laksana simtomatik saja. Tujuan tata laksana pada pasien dengan metastasis otak adalah memperpanjang survival jika memungkinkan dengan mengontrol defisit neurologis dan memberikan kualitas hidup yang baik. Skoring prognostik merupakan metode yang bermanfaat pada kasus metastasis otak, karena dengan dapat memperkirakan prognosis pasien maka dapat menentukan pilihan tata laksana yang tepat. Tata laksana agresif direkomendasikan pada penderita dengan status performance yang baik dan penyakit sistemik yang terkontrol. Adapun tata laksana paliatif ditujukan pada pasien dengan kondisi terminal atau ada komorbid lain yang menyertai. Beberapa skoring prognostik telah diajukan seperti, Recursive Partitioning Analysis (RPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM), dan Graded Prognostic Assessment (GPA). Recursive Partitioning Analysis dan GPA merupakan pilihan yang dapat diterapkan pada populasi pasien metastasis otak di Indonesia.Kata kunci:  Metastasis otak, skoring prognostik, survival rate 

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