External validation of the lung-molGPA to predict survival in patients treated with stereotactic radiotherapy for brain metastases of non-small cell lung cancer

Jeroen A Crouzen ¹, Mirjam E Mast ¹, Martijn Hakstege ¹

¹Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands.
²Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
³Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands.
⁴Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
⁵Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands.
⁶Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
⁷Department of Pulmonology, Haaglanden Medical Center, The Hague, The Netherlands.
⁸Department of Medical Oncology, Haaglanden Medical Center, The Hague, The Netherlands.
⁹Department of Medical Physics, Haaglanden Medical Center, The Hague, The Netherlands.
¹⁰Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands; Department of Radiotherapy, HollandPTC, Delft, The Netherlands.

⁰Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology +

|

June 26, 2024

View abstract on PubMed

Summary

The Lung-molGPA accurately predicts survival for non-small cell lung cancer brain metastases patients treated with stereotactic radiotherapy. This external validation confirms its utility in patient counseling.

Area Of Science

Oncology
Radiotherapy
Personalized Medicine

Background

Individualized prognostic models are crucial for personalized medicine in non-small cell lung cancer (NSCLC) brain metastases (BMs).
External validation of prognostic models like the Graded Prognostic Assessment (GPA) is essential before clinical implementation.
The updated Lung-molGPA model aims to improve survival estimation for NSCLC BMs patients.

Purpose Of The Study

To externally validate the updated Lung-molGPA prognostic model in a European cohort of NSCLC adenocarcinoma patients treated with stereotactic radiotherapy (SRT).
To assess the accuracy of the Lung-molGPA in predicting survival for patients with one or more BMs.

Main Methods

Retrospective analysis of 241 NSCLC adenocarcinoma patients treated with SRT for BMs.
Calculation of Lung-molGPA scores based on age, performance status, number of BMs, extracranial metastases, EGFR/ALK, and PD-L1 status.
Survival analysis using Kaplan-Meier, Cox proportional hazard models, and assessment of predictive performance via C-statistics and Brier scores.

Main Results

The Lung-molGPA demonstrated accurate survival predictions in the validation cohort (n=241).
Overall median survival was 15 months, with predicted and observed survival aligning well across most prognostic groups.
The model showed adequate discrimination and calibration, confirming its predictive accuracy.

Conclusions

The Lung-molGPA is externally validated and accurately predicts survival in European patients with NSCLC adenocarcinoma BMs treated with SRT.
The model is a valuable tool for counseling patients regarding their prognosis.
A slight overestimation of survival was noted in the most favorable prognostic group.

Keywords:

Adenocarcinoma of lung Anaplastic lymphoma kinase B7-H1 Antigen Brain neoplasm*/secondary ErbB receptors Prognosis