A new prognostic index and comparison to three other indices for patients with brain metastases: An analysis of 1,960 patients in the RTOG database
A new prognostic index and comparison to three other indices for patients with brain metastases: An analysis of 1,960 patients in the RTOG database
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DOI：
10.1016/j.ijrobp.2007.06.074
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发表时间：
2008-02-01
影响因子：
7
通讯作者：
Curran, Walter
中科院分区：
文献类型：
--
作者：
Sperduto, Paul W.;Berkey, Brian;Curran, Walter
目的：本研究的目的是介绍一种新的脑转移瘤患者的预后指标，并将其与三种已发表的指标进行比较。脑转移瘤的治疗方法差异很大。因此，一个良好的预后指数是重要的指导临床决策和成果research.Methods和材料：一个新的指数，因为现有的三个指数和新的数据（放射治疗肿瘤组9508）的局限性，因为其他开发。所有四个指标都是使用放射治疗肿瘤组数据库进行比较的，该数据库包含来自五项随机试验的1,960例脑转移患者。四个指数的能力，以区分其单独的类进行了统计。结果：递归分割分析（RPA）和新的分级预后评估（GPA）在各分类间的差异有统计学意义（P < 0.001），结论：新的预后评估指标GPA与RPA具有同样的预后价值，但比其他指标更具有预后价值。GPA是四个指数中主观性最小、量化最多、最容易使用的。未来的临床试验应将GPA与RPA进行比较，以前瞻性地验证这些发现。(C)2008年爱思唯尔公司
Purpose: The purpose of this study is to introduce a new prognostic index for patients with brain metastases and compare it with three published indices. Treatment for brain metastases varies widely. A sound prognostic index is thus important to guide both clinical decision making and outcomes research.Methods and Materials: A new index was developed because of limitations in the three existing indices and new data (Radiation Therapy Oncology Group 9508) are available since the others were developed. All four indices were compared using the Radiation Therapy Oncology Group database of 1,960 patients with brain metastases from five randomized trials. The ability of the four indices to distinguish its separate classes was determined statistically. Advantages and disadvantages of each index are discussed.Results: Recursive partitioning analysis (RPA) and the new Graded Prognostic Assessment (GPA) had the most statistically significant differences between classes (p < 0.001 for all classes).Conclusions: The new index, the GPA, is as prognostic as the RPA and more prognostic than the other indices. The GPA is the least subjective, most quantitative and easiest to use of the four indices. Future clinical trials should compare the GPA with the RPA to prospectively validate these findings. (C) 2008 Elsevier Inc.