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Prognostic Model for Intracranial Progression after Stereotactic Radiosurgery: A Multicenter Validation Study.
David J Carpenter1, Brahma Natarajan2, Muzamil Arshad3
1Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA.
Cancers
|November 11, 2022
Summary
A validated nomogram accurately predicts intracranial progression after stereotactic radiosurgery (SRS) for brain metastases. This tool helps stratify patients into low- and high-risk groups for optimized surveillance.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Stereotactic radiosurgery (SRS) is a standard treatment for brain metastases.
- Optimizing post-SRS surveillance requires accurate prediction of intracranial progression (IP).
Purpose of the Study:
- To validate a previously published nomogram for predicting post-SRS intracranial progression (IP).
- To assess the nomogram's utility in stratifying patients for surveillance.
Main Methods:
- Retrospective analysis of 890 patients undergoing SRS for brain metastases across two institutions.
- Patients were classified as low- or high-risk using a pre-existing IP nomogram.
- Kaplan-Meier analysis assessed overall survival (OS) and freedom from IP (FFIP); Cox models evaluated impacting parameters.
Main Results:
- 53% of patients were classified as high-risk by the nomogram.
- Median FFIP was significantly higher in low-risk (13.9 months) versus high-risk patients (7.6 months) (p < 0.0001).
- The nomogram effectively stratified patients based on post-SRS IP risk.
Conclusions:
- The validated IP nomogram is a reliable tool for stratifying brain metastases patients post-SRS.
- This stratification aids in optimizing surveillance strategies for improved patient outcomes.
- The nomogram provides a simple and quick method for risk assessment.
