Rades Dirk, Janssen Stefan, Bajrovic Amira, Veninga Theo, Fischer Dorothea, Schild Steven E
*Department of Radiation Oncology, University of Lubeck, Lubeck; †Medical Practice for Radiotherapy and Radiation Oncology, Hannover; ‡Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; §Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands; ∥Department of Gynecology and Obstetrics, University of Lubeck, Lubeck; ¶Department of Gynecology and Obstetrics, Ernst von Bergmann Hospital, Potsdam, Germany; and #Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, Arizona.
Int J Gynecol Cancer. 2017 Mar;27(3):597-602. doi: 10.1097/IGC.0000000000000899.
This study aimed to facilitate individualized treatment strategies for intracerebral metastases from gynecological cancers by creating a specific overall survival (OS) score.
METHODS/MATERIALS: Fifty-six patients irradiated for cerebral metastases from gynecological cancers were included. Eleven factors were retrospectively analyzed for OS: age, Eastern Cooperative Oncology Group (ECOG) performance score, cancer type, histology, histologic grading, initial stage, number of lesions, extracerebral metastases, time between cancer diagnosis and brain metastases treatment, recursive partitioning analysis class, and type of treatment. Independent predictors of OS were incorporated in the score (better OS, 1 point; worse OS, 0 points).
On Cox proportional hazards analysis, performance score (hazards ratio, 1.98; 95% confidence interval, 1.30-3.23; P = 0.001), no extracerebral metastases (3.34; 1.46-8.96; P = 0.003), and recursive partitioning analysis class 1 (3.27; 1.97-5.65; P < 0.001) were significant. The following points were assigned: ECOG score 1 to 2 = 1 point, ECOG score 3 to 4 = 0 points, no extracerebral metastases = 1 point, extracerebral metastases = 0 points. Sum scores were 0 (n = 32), 1 (n = 15), or 2 points (n = 9). Six-month OS rates were 6%, 67%, and 100%, respectively (P < 0.001).
A predictive tool including 3 groups with significantly different OS probabilities was designed for patients with cerebral metastases from gynecological cancers. This tool will aid in choosing individual treatments.
本研究旨在通过创建一个特定的总生存期（OS）评分来促进妇科癌症脑转移的个体化治疗策略。
方法/材料：纳入56例接受妇科癌症脑转移放疗的患者。对总生存期回顾性分析11个因素：年龄、东部肿瘤协作组（ECOG）体能状态评分、癌症类型、组织学、组织学分级、初始分期、病灶数量、脑外转移、癌症诊断与脑转移治疗之间的时间、递归分割分析类别和治疗类型。总生存期的独立预测因素被纳入评分（较好的总生存期，1分；较差的总生存期，0分）。
在Cox比例风险分析中，体能状态评分（风险比，1.98；95%置信区间，1.30 - 3.23；P = 0.001）、无脑外转移（3.34；1.46 - 8.96；P = 0.003）和递归分割分析类别1（3.27；1.97 - 5.65；P < 0.001）具有显著性。分配以下分数：ECOG评分1至2 = 1分，ECOG评分3至4 = 0分，无脑外转移 = 1分，脑外转移 = 0分。总分分别为0分（n = 32）、1分（n = 15）或2分（n = 9）。6个月总生存率分别为6%、67%和100%（P < 0.001）。
为妇科癌症脑转移患者设计了一种预测工具，该工具包含3组总生存期概率显著不同的患者。此工具将有助于选择个体化治疗。
