The Prognostic Values of Graded Prognostic Assessment (GPA) Index In Advanced Stage NSCLC Patients With Brain Metastasis

Year 2023, , 137 - 141, 23.03.2023

Ayse Kotek Sedef , Emre Uysal , Tanju Berber , Necla Gürdal , Berna Yıldırım

https://doi.org/10.18663/tjcl.1240361

Cited By: 1

Abstract

Purpose: Graded Prognostic Assessment (GPA) is a new prognostic index for patients with brain metastases. Brain metastasis is a common site of metastasis in lung cancers. Lung cancer-specific GPA scoring system is used. We aimed to assess the prognostic and predictive significance of Graded Prognostic Assessment (GPA) score in non small-cell lung cancer patients with brain metastasis.
Materials and Methods: This study was designed as a hospital-based retrospective observational case-series study. A total of 95 patients with brain metastatic NSCLC patients who were followed in two different oncology centers in Turkey between 2015 and 2021 have been included into this study. They were divided into 3 groups according to their GPA scores.
Results: The median age of the patients was 62 (range 44-89) years The patients were divided into 3 groups according to their GPA scores. 24 (25.2 %) patients had ‘’0-1’’ GPA score, 54 (56,8 %) patients had ‘’1,5-2’’ GPA score and 17 (18 %) patients had ‘’2,5-3’’ GPA score. The median follow-up time was 11 months and 89 (93.7%) patients died during follow-up. Overall survival (OS) was 8 months. Patients in the low (0-1) GPA scores had worst overall survival than those with higher GPA scores (4.7, 12.6 and 18.5 months respectively and p=0,001).
Conclusion: In this study, we have shown that GPA score is useful in evaluating the prognosis of NSCLC patients with brain metastasis

Keywords

GPA, Lung Cancer, Brain Metastasis

Supporting Institution

No

Project Number

No

Thanks

No

Beyin Metastazlı İleri Evre KHDAK Hastalarında GPA İndeksinin Prognostik Değeri

Abstract

Amaç: Derecelendirilmiş Prognostik Değerlendirme (GPA), beyin metastazı olan hastalar için yeni bir prognostik indekstir. Beyin metastazı, akciğer kanserlerinde sık görülen bir metastaz bölgesidir. Akciğer kanserine özgü GPA skorlama sistemi kullanılmaktadır. Beyin metastazı olan küçük hücreli dışı akciğer kanseri hastalarında Kademeli Prognostik Değerlendirme (GPA) skorunun prognostik ve prediktif önemini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Bu çalışma, hastane tabanlı retrospektif gözlemsel vaka serisi çalışması olarak tasarlandı. Bu çalışmaya 2015-2021 yılları arasında Türkiye'de iki farklı onkoloji merkezinde izlenen beyin metastatik KHDAK'li toplam 95 hasta dahil edildi. GPA puanlarına göre 3 gruba ayrıldılar.
Bulgular: Hastaların ortanca yaşı 62 (44-89) idi. Hastalar GPA'larına göre 3 gruba ayrıldı. 24 (%25,2) hastanın GPA'sı ''0-1'', 54 (%56,8) hastanın GPA 'sı ''1,5-2'' ve 17 (%18) hastanın GPA skoru ''2,5'-3'' arsasındaydı. Medyan takip süresi 11 aydı ve takipte 89 (%93,7) hasta öldü. Genel sağkalım (OS) 8 aydı. Düşük (0-1) GPA skorlarındaki hastalar, daha yüksek GPA skorlarına sahip olanlara göre en kötü genel sağ kalıma sahipti (sırasıyla 4.7, 12.6 ve 18.5 ay ve p=0,001).
Sonuç: Bu çalışmada beyin metastazı olan KHDAK hastalarının prognozunu değerlendirmede GPA skorunun yararlı olduğunu gösterdik.

Keywords

GPA, Lung Cancer, Brain Metastasis

Project Number

No

References

• 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61:69–90
• 2. Detterbeck FC, Boffa DJ, Tanoue LT. The new lung cancer staging system. Chest 2009; 136:260-71
• 3. Molina JR, Yang P, Cassivi SD et al. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc 2008;83:584-94.
• 4. Gavrilovic IT, Posner JB. Brain metastases: epidemiology and pathophysiology. J Neurooncol. 2005;75(1):5-14. [PubMed] [Google Scholar]
• 5. Park DM, Posner JB. Management of intracranial metastases: history In: Sawaya R, ed. Intracranial Metastases: Current Management Strategies. Oxford, England: Blackwell Publishing Ltd; 2004:3-19
• 6. Gaspar LE, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745-751, 1997
• 7. Sperduto PW, Berkey B, Gaspar LE, et al: A new prognostic index and comparison to three other indices for patients with brain metastases: An analysis of 1960 patients in the RTOG database. Int J Radiat Oncol Biol Phys 70:510-514, 2008
• 8. Komarnicky LT, Phillips TL, Martz K, et al: A randomized phase III protocol for the evaluation of misonidazole combined with radiation in the treatment of patients with brain metastases (RTOG79- 16). Int J Radiat Oncol Biol Phys 20:53-58, 1991
• 9. Sause WT, Scott C, Kirsch R, et al: Phase I/II trial of accelerated fractionation in brain metastases, RTOG 85-28. Int J Radiat Oncol Biol Phys 26:653- 657, 1993
• 10. Sperduto CM, Watanabe Y, Mullan J, et al: A validation study of a new prognostic index for patients with brain metastases: The graded prognostic assessment. J Neurosurg 109:87-89, 2008
• 11. Sperduto PW, Chao ST, Sneed PK, et al: Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: A multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 77:655-661, 2010
• 12. Sperduto PW: What is your patient’s GPA and why does it matter? Managing brain metastases and the cost of hope. Int J Radiat Oncol Biol Phys 77:643-644, 2010
• 13. Sperduto PW, Kased N, Roberge D, et al. Summary report on the graded prognostic assessment: An accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 2012;30:419–425.
• 14. Sperduto PW, Yang TJ, Beal K, et al. Estimating survival in patients with lung cancer and brain metastases: An update of the graded prognostic assessment for lung cancer using molecular markers (lungmolGPA). JAMA Oncol 2017;3:827–831.