Journal article
Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA)
Clinical and translational radiation oncology, Vol.18, pp.39-45
09/01/2019
DOI: 10.1016/j.ctro.2019.06.007
PMCID: PMC6612649
PMID: 31341974
Abstract
Background: Patients with gastrointestinal cancers and brain metastases (BM) represent a unique and heterogeneous population. Our group previously published the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with GI cancers (GI-GPA) (1985-2007, n = 209). The purpose of this study is to update the GI-GPA based on a larger contemporary database.
Methods: An IRB-approved consortium database analysis was performed using a multi-institutional (18), multi-national (3) cohort of 792 patients with gastrointestinal (GI) cancers, with newly-diagnosed BM diagnosed between 1/1/2006 and 12/31/2017. Survival was measured from date of first treatment for BM. Multiple Cox regression was used to select and weight prognostic factors in proportion to their hazard ratios. These factors were incorporated into the updated GI-GPA.
Results: Median survival (MS) varied widely by primary site and other prognostic factors. Four significant factors (KPS, age, extracranial metastases and number of BM) were used to formulate the updated GI-GPA. Overall MS for this cohort remains poor; 8 months. MS by GPA was 3, 7, 11 and 17 months for GPA 0-1, 1.5-2, 2.5-3.0 and 3.5-4.0, respectively. >30% present in the worst prognostic group (GI-GPA of <= 1.0).
Conclusions: Brain metastases are not uncommon in GI cancer patients and MS varies widely among them. This updated GI-GPA index improves our ability to estimate survival for these patients and will be useful for therapy selection, end-of-life decision-making and stratification for future clinical trials. A user-friendly, free, on-line app to calculate the GPA score and estimate survival for an individual patient is available at brainmetgpa.com. (C) 2019 Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.
Details
- Title: Subtitle
- Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA)
- Creators
- Paul W. Sperduto - Minneapolis Radiation Oncology and University of Minnesota Gamma Knife Center, USAPenny Fang - The University of Texas MD Anderson Cancer CenterJing Li - The University of Texas MD Anderson Cancer CenterWilliam Breen - Mayo ClinicPaul D. Brown - Mayo ClinicDaniel Cagney - Dana-Farber Cancer InstituteAyal Aizer - Dana-Farber Cancer InstituteJames B. Yu - Yale UniversityVeronica Chiang - Yale UniversitySupriya Jain - University of Colorado Anschutz Medical CampusLaurie E. Gaspar - University of Colorado BoulderSten Myrehaug - Sunnybrook HospitalArjun Sahgal - Sunnybrook HospitalSteve Braunstein - University of California, San FranciscoPenny Sneed - University of California, San FranciscoBrent Cameron - Vanderbilt University Medical CenterAlbert Attia - Vanderbilt University Medical CenterJason Molitoris - University of Maryland, College ParkCheng-Chia Wu - Columbia University Medical CenterTony J. C. Wang - Columbia University Medical CenterNatalie A. Lockney - Memorial Sloan Kettering Cancer CenterKathryn Beal - Memorial Sloan Kettering Cancer CenterJessica Parkhurstm - Univ Iowa, Iowa City, IA 52242 USAJohn M. Buatti - University of IowaRyan Shanley - University of MinnesotaEmil Lou - University of MinnesotaDaniel D. Tandberg - Duke UniversityJohn P. Kirkpatrick - Duke UniversityDiana Shi - Massachusetts General HospitalHelen A. Shih - Massachusetts General HospitalMichael Chuong - Miami Cancer Institute, USAHirotake Saito - Niigata UniversityHidefumi Aoyama - Niigata UniversityLaura Masucci - Centre Hospitalier de l’Université de MontréalDavid Roberge - Centre Hospitalier de l’Université de MontréalMinesh P. Mehta - Miami Cancer Institute, USA
- Resource Type
- Journal article
- Publication Details
- Clinical and translational radiation oncology, Vol.18, pp.39-45
- DOI
- 10.1016/j.ctro.2019.06.007
- PMID
- 31341974
- PMCID
- PMC6612649
- NLM abbreviation
- Clin Transl Radiat Oncol
- ISSN
- 2405-6308
- eISSN
- 2405-6308
- Publisher
- Elsevier
- Number of pages
- 7
- Grant note
- P30 CA77598 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA P30CA086862 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) UL1TR002494 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1TR002494 / National Institutes of Health (NIH) from the National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 09/01/2019
- Academic Unit
- Radiation Oncology; Neurosurgery; Otolaryngology
- Record Identifier
- 9984303904602771
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