new consensus paper on prognosis/results with diff treatments for brain mets

[Lani]

Among the authors is Penny Sneed, radiation oncologist at UCSF whom we have mentioned before

In the original paper is a chart showing the different ways the mets were treated ie, WBR, SRS etc and results

results are divided into her2 and luminal B subtypes, among her2+ bc mets

J Clin Oncol. 2011 Dec 27. [Epub ahead of print]
Summary Report on the Graded Prognostic Assessment: An Accurate and Facile Diagnosis-Specific Tool to Estimate Survival for Patients With Brain Metastases.
Sperduto PW, Kased N, Roberge D, Xu Z, Shanley R, Luo X, Sneed PK, Chao ST, Weil RJ, Suh J, Bhatt A, Jensen AW, Brown PD, Shih HA, Kirkpatrick J, Gaspar LE, Fiveash JB, Chiang V, Knisely JP, Sperduto CM, Lin N, Mehta M.
Source
Paul W. Sperduto, University of Minnesota Gamma Knife, Minneapolis Radiation Oncology; Ryan Shanley and Xianghua Luo, University of Minnesota, Minneapolis; Ashley W. Jensen and Paul D. Brown, Mayo Clinic, Rochester, MN; Norbert Kased and Penny K. Sneed, University of California, San Francisco, San Francisco, CA; Zhiyuan Xu, Samuel T. Chao, Robert J. Weil, and John Suh, Cleveland Clinic, Cleveland, OH; Amit Bhatt, University of Wisconsin, Madison, WI; Helen A. Shih, Massachusetts General Hospital, Harvard Medical School; Nancy Lin, Dana-Farber Cancer Institute, Boston, MA; John Kirkpatrick, Duke University Medical Center, Durham, NC; Laurie E. Gaspar, University of Colorado School of Medicine, Aurora, CO; John B. Fiveash, University of Alabama Medical Center at Birmingham, Birmingham, AL; Veronica Chiang, Yale University School of Medicine and Yale Cancer Center, New Haven, CT; Jonathan P.S. Knisely, Hofstra University School of Medicine and North Shore-Long Island Jewish Health System, Manhasset, NY; Christina Maria Sperduto, Dartmouth College, Hanover, NH; Minesh Mehta, Northwestern University, Chicago, IL; and David Roberge, McGill University Health Center, Montreal, Quebec, Canada.
Abstract
PURPOSEOur group has previously published the Graded Prognostic Assessment (GPA), a prognostic index for patients with brain metastases. Updates have been published with refinements to create diagnosis-specific Graded Prognostic Assessment indices. The purpose of this report is to present the updated diagnosis-specific GPA indices in a single, unified, user-friendly report to allow ease of access and use by treating physicians. METHODSA multi-institutional retrospective (1985 to 2007) database of 3,940 patients with newly diagnosed brain metastases underwent univariate and multivariate analyses of prognostic factors associated with outcomes by primary site and treatment. Significant prognostic factors were used to define the diagnosis-specific GPA prognostic indices. A GPA of 4.0 correlates with the best prognosis, whereas a GPA of 0.0 corresponds with the worst prognosis.ResultsSignificant prognostic factors varied by diagnosis. For lung cancer, prognostic factors were Karnofsky performance score, age, presence of extracranial metastases, and number of brain metastases, confirming the original Lung-GPA. For melanoma and renal cell cancer, prognostic factors were Karnofsky performance score and the number of brain metastases. For breast cancer, prognostic factors were tumor subtype, Karnofsky performance score, and age. For GI cancer, the only prognostic factor was the Karnofsky performance score. The median survival times by GPA score and diagnosis were determined. CONCLUSIONPrognostic factors for patients with brain metastases vary by diagnosis, and for each diagnosis, a robust separation into different GPA scores was discerned, implying considerable heterogeneity in outcome, even within a single tumor type. In summary, these indices and related worksheet provide an accurate and facile diagnosis-specific tool to estimate survival, potentially select appropriate treatment, and stratify clinical trials for patients with brain metastases.
PMID: 22203767 [PubMed - as supplied by publisher]