Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials
Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials
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DOI：
10.1016/s0360-3016(96)00619-0
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发表时间：
1997-03-01
影响因子：
7
通讯作者：
Byhardt, R
中科院分区：
文献类型：
--
作者：
Gaspar, L;Scott, C;Byhardt, R
目的：最近有报道称，放射外科或立体定向手术等新方法治疗脑转移瘤的结果很有希望，这些结果是由于单独的治疗，还是部分归因于患者的选择？认为有必要对既往放射治疗肿瘤组（RTOG）脑转移研究中的肿瘤/患者特征和治疗变量进行分析，以充分评价这些新干预措施的获益，方法和材料：该数据库包括来自1979年至1993年进行的三项连续RTOG试验的1200名患者，这些试验测试了几种不同的剂量分割方案和辐射增敏剂，使用递归分割分析（RPA），一种根据预后意义创建回归树的统计方法，分析了18个预处理特征和3个治疗相关变量。（中位数：7.1个月），在年龄< 65岁、Karnofsky行为状态（KPS）至少为70、且原发性肿瘤控制在脑内为唯一转移部位的患者中观察到，最糟糕的生存所有其他患者在观察到的生存期方面具有相对较小的差异，中位数为4.2个月。结论：基于该分析，我们建议以下三类：KPS大于或等于70，< 65岁，原发灶控制，无颅外转移的患者; 3级：KPS < 70;第2类-所有其他，使用这些类别或阶段，可以在同质患者组上测试新的治疗技术，（C）1997 Elsevier Science Inc.
Purpose: Promising results from new approaches such as radiosurgery or stereotactic surgery of brain metastases have recently been reported, Are these results due to the therapy alone or can the results be attributed in part to patient selection? An analysis of tumor/patient characteristics and treatment variables in previous Radiation Therapy Oncology Group (RTOG) brain metastases studies was considered necessary to fully evaluate the benefit of these new interventions,Methods and Materials: The database included 1200 patients from three consecutive RTOG trials conducted between 1979 and 1993, which tested several different dose fractionation schemes and radiation sensitizers, Using recursive partitioning analysis (RPA), a statistical methodology which creates a regression tree according to prognostic significance, eighteen pretreatment characteristics and three treatment-related variables were analyzed,Results: According to the RPA tree the best survival (median: 7.1 months) was observed in patients < 65 years of age with a Karnofsky Performance Status (KPS) of at least 70, and a controlled primary tumor with the brain the only site of metastases, The worst survival (median: 2.3 months) was seen in patients with a KPS less than 70, All other patients had relatively minor differences in observed survival, with a median of 4.2 months,Conclusions: Based on this analysis, we suggest the following three classes: Class 1: patients with KPS greater than or equal to 70, < 65 Sears of age with controlled primary and no extracranial metastases; Class 3: KPS < 70; Class 2- all others, Using these classes or stages, new treatment techniques can be tested on homogeneous patient groups, (C) 1997 Elsevier Science Inc.