Dividing patients with brain metastases into classes derived from the RTOG recursive partitioning analysis (RPA) with emphasis on prognostic poorer patient groups

Abstract

Background. The aim of our study was to investigate whether selecting the patients with brain metastases by classifying them into three classes according to the results of the recursive partitioning analysis (RPA) of the Radiation Therapy Oncology Group (RTOG) is useful or not for further decision concerning altered treatment schedules in patients.

Patients and methods. The investigated group included 57 male and 48 female patients having received whole brain radiotherapy in a total dose of 30 Gy / 3 Gy daily / 5 days a week. Patients who had surgical excision of brain metastases or had radiosurgical intervention were excluded. All patients were stratified according to the findings of RPA (Class I: Karnofsky Performance Status (KPS) =70, age < 65, controlled primary tumour, no other metastases; Class II: not Class I or III; Class III KPS < 70).

Results. The six/twelve months survival probability for classes I to III was 80 %/44 %, 43 %/17% and 6%/0 %, respectively. KPS and extracerebral tumour activity, but not age (<> 65) had an impact on survival according to multivariate analysis.

Conclusions. Selecting the patients by dividing them into the three RPA classes seems to be useful. Considering the short survival time in RPA Class III, those patients might be well treated with a shorter treatment course.