ESTRO 2022 - Abstract Book

S981

Abstract book

ESTRO 2022

PO-1157 Comprehensive comparison of prognostic scores for patients with newly diagnosed brain metastases

J. Kraft 1,2 , J.E. van Timmeren 2 , S. Frei 2 , M. Mayinger 2 , K. Borsky 2 , C. Kirchner 3,2 , L.S. Stark 2 , S. Tanadini-Lang 2 , F. Wolpert 4 , M. Weller 4 , M. Guckenberger 2 , N. Andratschke 2 1 University Hospital Würzburg, Department of Radiation-Oncology, Würzburg, Germany; 2 University Hospital Zurich, Department of Radiation-Oncology, Zurich, Switzerland; 3 Marienhospital Stuttgart, Department of Radiation-Oncology, Stuttgart, Germany; 4 University Hospital Zurich, Department of Neurology, Zurich, Switzerland Purpose or Objective Numerous prognostic scores for assessment of patients' overall survival after the diagnosis of brain metastases have been developed in the last decades. Since the introduction of the first prognostic scores, overall survival of patients has dramatically changed, and it is unclear whether existing older scores are still relevant and can still compete with newer scores. The aim of our work is to provide a comprehensive overview and performance comparison of existing scores for brain metastases in a modern patient collective treated with upfront stereotactic radiosurgery for newly diagnosed brain metastases. Materials and Methods Overall seventeen previously published prognostic scores were included for the comparison and were calculated for 470 patients receiving upfront stereotactic radiosurgery between 2014 and 2020. Prognostic scores were evaluated and ranked based on restricted mean survival time (RMST) and partial likelihood. Univariable and multivariable analysis were used to identify prognostic factors for OS. In addition, a score solely based on the assessment of the performance status was calculated and included in the performance comparison. Results The median OS of the cohort was 15.8 months (95% C.I.: 13.4-20.1) Prognostic scores solely based on clinical parameters could be calculated for all patients (n=470). For 310 patients with a complete dataset of laboratory parameters, five additional laboratory scores could be calculated and were included in a separate overall ranking. When considering the entire cohort, GGS, the WBRT Score of Rades et al., RPA and a score based solely on the assessment of performance status showed the highest partial likelihood. In the evaluation of 310 patients with complete laboratory dataset and with inclusion of the laboratory scores, EC-GPA, LabBM, ECS, and the modified Glasgow Score displaced all the previously mentioned ones. RPA showed the largest between-group differences in terms of RMST. Multivariate analysis revealed laboratory parameters (hemoglobine, albumin, LDH and C-reactive protein) and performance status as the most significant parameters associated with OS.

Table 1 - Overview of prognostic scores and ranking based on partial likelihood not incorporated into the final comparison: *(treatment with corticosteroids), **(two subgroups), ***(evaluated in histology- specific subgroups)