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Validation of the graded prognostic assessment for gastrointestinal cancers with brain metastases (GI-GPA)

Authors
  • Nieder, Carsten1, 2
  • Hintz, Mandy3
  • Popp, Ilinca3, 4
  • Bilger, Angelika3, 4
  • Grosu, Anca L.3, 4
  • 1 Nordland Hospital, Bodø, 8092, Norway , Bodø (Norway)
  • 2 University of Tromsø, Tromsø, 9037, Norway , Tromsø (Norway)
  • 3 University Hospital Freiburg, Freiburg, 79106, Germany , Freiburg (Germany)
  • 4 German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany , Freiburg (Germany)
Type
Published Article
Journal
Radiation Oncology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Feb 13, 2020
Volume
15
Issue
1
Identifiers
DOI: 10.1186/s13014-020-1484-9
Source
Springer Nature
Keywords
License
Green

Abstract

PurposeThe purpose of this study was to validate a new prognostic model (GI-GPA) originally derived from a multi-center database (USA, Canada, Japan).Patients and MethodsThis retrospective study included 92 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy. Information about age, extracranial spread, number of brain metastases, performance status and other variables was collected. The GI-GPA score was calculated as described by Sperduto et al.ResultsMedian survival was 4 months. The corresponding figures for the 4 different prognostic strata were 2.3, 4.4, 9.4 and 12.7 months, respectively (p = 0.0001). Patients whose management included surgical resection had longer median survival than those who were treated with other approaches (median 11.9 versus 3.0 months, p = 0.002). Comparable results were seen for additional systemic therapy (median 8.5 versus 3.5 months, p = 0.01).ConclusionThese results confirm the validity of the GI-GPA in an independent dataset from a different geographical region, despite the fact that overall survival was shorter in all prognostic strata, compared to Sperduto et al. Potential explanations include differences in molecular tumor characteristics and treatment selection, both brain metastases-directed and extracranially. Long-term survival beyond 5 years is possible in a small minority of patients.

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