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. 2024 Mar 26;31(4):1739-1751.
doi: 10.3390/curroncol31040132.

Prognosis versus Actual Outcomes in Stereotactic Radiosurgery of Brain Metastases: Reliability of Common Prognostic Parameters and Indices

Julian Mangesius  1 , Thomas Seppi  1 , Christoph Reinhold Arnold  1 , Stephanie Mangesius  2 , Johannes Kerschbaumer  3 , Matthias Demetz  3 , Danijela Minasch  1 , Samuel Moritz Vorbach  1 , Manuel Sarcletti  1 , Peter Lukas  1 , Meinhard Nevinny-Stickel  1 , Ute Ganswindt  1
Affiliations

Prognosis versus Actual Outcomes in Stereotactic Radiosurgery of Brain Metastases: Reliability of Common Prognostic Parameters and Indices

Julian Mangesius et al. Curr Oncol. .

Abstract

This study aims to evaluate the clinical outcome of stereotactic radiosurgery as the sole treatment for brain metastases and to assess prognostic factors influencing survival. A total of 108 consecutive patients with 213 metastases were retrospectively analyzed. Treatment was determined with close-meshed MRI follow-up. Various prognostic factors were assessed, and several prognostic indices were compared regarding their reliability to estimate overall survival. Median overall survival was 15 months; one-year overall survival was 50.5%. Both one- and two-year local controls were 90.9%. The rate of new metastases after SRS was 49.1%. Multivariate analysis of prognostic factors revealed that the presence of extracranial metastases, male sex, lower KPI, and progressive extracranial disease were significant risk factors for decreased survival. Of all evaluated prognostic indices, the Basic Score for Brain Metastases (BSBMs) showed the best correlation with overall survival. A substantial survival advantage was found for female patients after SRS when compared to male patients (18 versus 9 months, p = 0.003). SRS of brain metastasis is a safe and effective treatment option when frequent monitoring for new metastases with MRI is performed. Common prognostic scores lack reliable estimation of survival times. Female sex should be considered as an additional independent positive prognostic factor influencing survival.

Keywords: brain metastases; outcome; prognosis; prognostic scores; radiosurgery; sex differences.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves of overall survival, local control, and distant intracranial control.
Figure 2
Figure 2
Subgroup-categorized Kaplan–Meier curves of overall survival calculated for six common prognostic indices.
Figure 3
Figure 3
Comparative receiver operating characteristic curves (ROCCs) for each prognostic index estimating one-year survival probability after SRS. Predictive power of each PI is indicated by area under the curve of ROCC. Larger area under the curve indicates greater prognostic potential.
See this image and copyright information in PMC

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