Hou Ru, Li Hongwei, Cao Jianzhong, Song Xin, Zhang Xiaqin, Wang Weili
Shanxi Medical University, Taiyuan, China.
Department of Radiotherapy, Shanxi Province Cancer Hospital and Affiliated Cancer Hospital of Shanxi Medical University, Taiyuan, China. Email:
Ann Palliat Med. 2021 Jan;10(1):29-36. doi: 10.21037/apm-20-1819. Epub 2021 Jan 4.
A new disease-specific prognostic score (Disease-specific Prognostic Score for Patients With Brain Metastases From Small-cell Lung Cancer termed BMS-Score) was published to clarify the prognosis of patients with brain metastasis (BM) of small cell lung cancer (SCLC) treated with whole brain radiotherapy (WBRT). The purpose of the present study was to validate the prognostic value of the newly proposed BMS-Score through comparison with three other previously published prognostic indices.
In total, 451 patients with BM of SCLC treated with WBRT at the Shanxi Province Cancer Hospital from January 2010 to December 2019 were included. The clinical characteristics of all patients were recorded and follow-up was through April 2020. Overall survival (OS) was calculated by Kaplan-Meier analysis, and univariate and multivariate analyses were used to calculate the prognostic cofactors. The concordance index (C-index) was used to assess the prognostic value of the following four prognostic systems: recursive partitioning analysis (RPA), diagnosis-specific graded prognostic assessment (DS-GPA), basic score for brain metastases (BSBM), and the newly proposed BMS-Score.
The independent factors affecting the prognosis of SCLC patients with BM included the Karnofsky performance score (KPS), number of brain metastases, extracranial metastases (ECM) state, and whether treatment had been received before BM. RPA, BSBM, DS-GPA, and BMS-Score log-rank test P values were all less than 0.001 among each group (P<0.001). The C-indices of the four groups were 0.554, 0.584, 0.588, and 0.643, respectively.
The four prognostic scoring systems exhibited medium predictive value for SCLC. The BMS-Score had the best applicability compared with the other three prognosis indices.
一种新的疾病特异性预后评分（小细胞肺癌脑转移患者的疾病特异性预后评分，称为BMS评分）已发表，以明确接受全脑放疗（WBRT）的小细胞肺癌（SCLC）脑转移（BM）患者的预后。本研究的目的是通过与其他三个先前发表的预后指标进行比较，验证新提出的BMS评分的预后价值。
纳入2010年1月至2019年12月在山西省肿瘤医院接受WBRT治疗的451例SCLC脑转移患者。记录所有患者的临床特征，并随访至2020年4月。采用Kaplan-Meier分析计算总生存期（OS），并采用单因素和多因素分析计算预后协同因素。一致性指数（C指数）用于评估以下四种预后系统的预后价值：递归划分分析（RPA）、诊断特异性分级预后评估（DS-GPA）、脑转移基本评分（BSBM）和新提出的BMS评分。
影响SCLC脑转移患者预后的独立因素包括卡氏功能状态评分（KPS）、脑转移灶数量、颅外转移（ECM）状态以及BM前是否接受过治疗。每组中RPA、BSBM、DS-GPA和BMS评分的对数秩检验P值均小于0.001（P<0.001）。四组的C指数分别为0.554、0.584、0.588和0.643。
四种预后评分系统对SCLC均具有中等预测价值。与其他三个预后指标相比，BMS评分具有最佳适用性。
