Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases
Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases
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DOI：
10.1016/s0360-3016(00)00547-2
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发表时间：
2000-07-01
影响因子：
7
通讯作者：
Curran, W
中科院分区：
文献类型：
--
作者：
Gaspar, LE;Scott, C;Curran, W
目的：放射治疗肿瘤学组 (RTOG) 之前使用大型数据库的递归分区分析 (RPA) 开发了脑转移瘤的三个预后类别，这些类别基于卡诺夫斯基体能状态 (KPS)、原发肿瘤状态、颅外系统转移的存在和年龄。RTOG 91-04 的分析被认为是重要的，RTOG 91-04 是一项比较两种剂量分割方案的随机研究，并与已建立的 RTOG 数据库进行比较方法和材料：共有 445 名患者被随机分配参加 RTOG 91-04，这是一项加速超分割与加速分割的 III 期研究，两个治疗组之间在生存方面没有观察到差异。该分析包括四百三十二名患者。大多数患者年龄在 65 岁以下，KPS 70-80，原发肿瘤得到控制，且仅有脑转移。最初的 RPA 分为三个类别，但只有 RPA I 类和 II 类患者符合 RTOG 91-04 的条件。结果：对于 RPA I 类，91-04 和数据库的中位生存时间分别为 6.2 个月和 7.1 个月。 91-04 的 1 年生存率为 29%，而数据库为 32%。两种生存分布没有显着差异（p = 0.72）。对于 II 类 RPA，91-04 的中位生存时间为 3.8 个月，而数据库为 4.2 个月。 91-04 和数据库的 1 年生存率分别为 12% 和 16%（p = 0.22）。 结论：该分析表明 RPA 分类对于历史比较是有效且可靠的，RTOG 和其他临床试验组织者目前都应利用此 RPA 分类作为临床试验的分层因素。 (C) 2000 爱思唯尔科学公司。
Purpose: The Radiation Therapy Oncology Group (RTOG) previously developed three prognostic classes for brain metastases using recursive partitioning analysis (RPA) of a large database, These classes were based on Karnofsky performance status (KPS), primary tumor status, presence of extracranial system metastases, and age, An analysis of RTOG 91-04, a randomized study comparing two dose-fractionation schemes with a comparison to the established RTOG database, was considered important to validate the RPA classes.Methods and Materials: A total of 445 patients were randomized on RTOG 91-04, a Phase III study of accelerated hyperfractionation versus accelerated fractionation, No difference was observed between the two treatment arms with respect to survival. Four hundred thirty-two patients were included in this analysis. The majority of the patients were under age 65, had KPS 70-80, primary tumor controlled, and brain-only metastases. The initial RPA had three classes, but only patients in RPA Classes I and II were eligible for RTOG 91-04.Results: For RPA Class I, the median survival time was 6.2 months and 7.1 months for 91-04 and the database, respectively. The 1-year survival was 29% for 91-04 versus 32% for the database. There was no significant difference in the two survival distributions (p = 0.72). For RPA Class II, the median survival time was 3.8 months for 91-04 versus 4.2 months for the database. The 1-year survival was 12% and 16% for 91-04 and the database, respectively (p = 0.22).Conclusion: This analysis indicates that the RPA classes are valid and reliable for historical comparisons, Both the RTOG and other clinical trial organizers should currently utilize this RPA classification as a stratification factor for clinical trials. (C) 2000 Elsevier Science Inc.