Online citations, reference lists, and bibliographies.
← Back to Search

Recursive Partitioning Analysis (RPA) Of Prognostic Factors In Three Radiation Therapy Oncology Group (RTOG) Brain Metastases Trials.

L. Gaspar, C. Scott, M. Rotman, S. Asbell, T. Phillips, Todd H. Wasserman, W. G. Mckenna, R. Byhardt
Published 1997 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
PURPOSE Promising results from new approaches such as radiosurgery or stereotactic surgery of brain metastases have recently been reported. Are these results due to the therapy alone or can the results be attributed in part to patient selection? An analysis of tumor/patient characteristics and treatment variables in previous Radiation Therapy Oncology Group (RTOG) brain metastases studies was considered necessary to fully evaluate the benefit of these new interventions. METHODS AND MATERIALS The database included 1200 patients from three consecutive RTOG trials conducted between 1979 and 1993, which tested several different dose fractionation schemes and radiation sensitizers. Using recursive partitioning analysis (RPA), a statistical methodology which creates a regression tree according to prognostic significance, eighteen pretreatment characteristics and three treatment-related variables were analyzed. RESULTS According to the RPA tree the best survival (median: 7.1 months) was observed in patients < 65 years of age with a Karnofsky Performance Status (KPS) of at least 70, and a controlled primary tumor with the brain the only site of metastases. The worst survival (median: 2.3 months) was seen in patients with a KPS less than 70. All other patients had relatively minor differences in observed survival, with a median of 4.2 months. CONCLUSIONS Based on this analysis, we suggest the following three classes: Class 1: patients with KPS > or = 70, < 65 years of age with controlled primary and no extracranial metastases; Class 3: KPS < 70; Class 2- all others. Using these classes or stages, new treatment techniques can be tested on homogeneous patient groups.
This paper references
10.1056/NEJM199002223220802
A randomized trial of surgery in the treatment of single metastases to the brain.
R. Patchell (1990)
10.1093/BIOMET/75.2.383
A stagewise rejective multiple test procedure based on a modified Bonferroni test
G. Hommel (1988)
10.1016/0360-3016(93)90838-M
Iridium brachytherapy for eyelids carcinomas. Long term results in 251 patients
N. Daly-Schveitzer (1993)
10.1016/0360-3016(93)90284-3
Phase I/II trial of accelerated fractionation in brain metastases RTOG 85-28.
W. Sause (1993)
10.1007/978-1-4612-4380-9_25
Nonparametric Estimation from Incomplete Observations
E. L. Kaplan (1958)
10.1016/0360-3016(94)90098-1
A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis.
J. Flickinger (1994)
10.1016/0360-3016(93)90840-R
Stereotaxic radiosurgery of brain metastases: The influence of number of lesions on survival
J. Joseph (1993)
10.1093/JNCI/85.9.690
Supratentorial malignant gliomas: risk patterns and therapy.
R. Kaplan (1993)
10.1093/BIOMET/76.3.624
A comparison of two modified Bonferroni procedures
G. Hommel (1989)
10.1016/0360-3016(90)90142-7
The influence of extent and local management on the outcome of radiotherapy for brain metastases.
P. Hoskin (1990)
10.1016/0360-3016(92)90762-7
Stereotaxic radiosurgery for brain metastases: the importance of adjuvant whole brain irradiation.
B. G. Fuller (1992)
10.1093/JNCI/85.9.704
Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials.
W. Curran (1993)
10.3171/JNS.1992.77.4.0531
Resection for solitary brain metastasis. Role of adjuvant radiation and prognostic variables in 229 patients.
S. Smalley (1992)
10.1016/0360-3016(94)90558-4
The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age.
E. M. Noordijk (1994)
10.1038/bjc.1977.1
Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples.
R. Peto (1977)
10.1016/0360-3016(95)00168-X
Results of a randomized comparison of radiotherapy and bromodeoxyuridine with radiotherapy alone for brain metastases: report of RTOG trial 89-05.
T. Phillips (1995)
10.1097/00000421-199010000-00013
Solitary Brain Metastasis: Results of an RTOG/SWOG Protocol Evaluation Surgery + RT versus RT Alone
W. Sause (1990)
10.1016/0360-3016(91)90137-S
A randomized phase III protocol for the evaluation of misonidazole combined with radiation in the treatment of patients with brain metastases (RTOG-7916).
L. Komarnicky (1991)
Tree-structured survival analysis.
L. Gordon (1985)
10.1016/0360-3016(89)90483-5
Identification of an optimal subgroup for treatment evaluation of patients with brain metastases using RTOG study 7916.
M. Diener-West (1989)
10.3171/JNS.1992.76.3.0444
Stereotactic radiosurgical treatment of brain metastases.
J. Adler (1992)
10.1016/0360-3016(94)90732-3
Primary cns lymphoma: Long-term results of an intensive combined modality therapy
J. Yahalom (1994)
10.2307/2530120
A qualitative discrepancy between censored data rank tests.
R. Prentice (1979)
10.1002/ANA.410330605
Treatment of single brain metastasis: Radiotherapy alone or combined with neurosurgery
Charles J. Vecht (1993)



This paper is referenced by
10.1007/978-3-319-22581-4_9
Concepts of Radiotherapy in Cancer of Unknown Primary
David Krug (2016)
10.1007/s00520-013-1840-5
Best supportive care in patients with brain metastases and adverse prognostic factors: development of improved decision aids
C. Nieder (2013)
10.14735/AMKO2015352
Utilization of Prognostic Indexes for Patients with Brain Metastases in Daily Radiotherapy Routine -  is the Complexity and Intricacy Still an Issue?
Tomas Kazda (2015)
10.4172/2155-9562.1000340
Radiosurgery and Stereotactic Radiotherapy for Brain MetastasesAccording the New Prognostic Indexes: our Preliminary Experience
V. Borzillo (2015)
10.1016/j.ijrobp.2008.03.009
Memory function before and after whole brain radiotherapy in patients with and without brain metastases.
G. Welzel (2008)
10.3816/CLC.2009.n.024
Management and prognosis in synchronous solitary resected brain metastasis from non-small-cell lung cancer.
A. Louie (2009)
10.1016/j.ijrobp.2009.09.028
Validity of the graded prognostic assessment-derived index to predict brain-metastatic patients' survival after Gamma Knife radiosurgery.
Shang-Ming Chiou (2010)
10.1684/BDC.2011.1337
Les métastases cérébrales des cancers du sein : qui, quand, et comment les opérer ?
Guillaume Dutertre (2011)
10.1016/j.ijrobp.2011.10.018
Subclassification of recursive partitioning analysis Class II patients with brain metastases treated radiosurgically.
M. Yamamoto (2012)
10.1007/s15004-013-0673-1
Prognose von Patienten mit Hirnmetastasen besser abschätzen
Hartmut T. Klages (2013)
10.1016/B978-0-12-407710-2.00026-6
Metastatic Disease and the Nervous System
Jasmin Jo (2014)
10.4103/sni.sni_480_17
The concept of rapid rescue radiosurgery in the acute management of critically located brain metastases: A retrospective short-term outcome analysis
G. Sinclair (2018)
10.1016/S0360-3016(01)02772-9
Metastatic melanoma to the brain: prognostic factors after gamma knife radiosurgery.
C. Yu (2002)
10.1097/COC.0b013e318280d7be
Prognostic Factors for Overall Survival After Radiosurgery for Brain Metastases From Melanoma
David M. Marcus (2014)
10.1186/s13014-015-0367-y
Local control after radiosurgery for brain metastases: predictive factors and implications for clinical decision
Tâmara Ribeiro de Azevedo Santos (2015)
10.21873/anticanres.13379
Diagnosis-specific WBRT-30-CRC Score for Estimating Survival of Patients Irradiated for Brain Metastases from Colorectal Cancer
D. Rades (2019)
10.1016/j.ijsu.2017.05.033
Prognostic factors in patients treated with surgery for brain metastases: A single-center retrospective analysis of 125 patients.
Z. Liu (2017)
10.1016/J.CANRAD.2011.03.007
Expérience de l’irradiation encéphalique totale avec escalade de dose focalisée pour le traitement des métastases cérébrales uniques d’un carcinome bronchopulmonaire
A. Levy (2011)
10.1016/J.IJROBP.2012.07.368
The Effect of Tumor Subtype on the Time From Primary Diagnosis to Development of Brain Metastases and Survival in Women With Breast Cancer
Paul W. Sperduto (2012)
10.3779/j.issn.1009-3419.2014.12.10
[Advances in treatment of brain metastases from primary non-small cell lung cancer].
G. Lin (2014)
10.3171/2016.2.JNS1633
BRAF V600E mutation and BRAF kinase inhibitors in conjunction with stereotactic radiosurgery for intracranial melanoma metastases.
Z. Xu (2017)
10.1002/9781118592168.CH40
Central Nervous System and Peripheral Nerves
D. Ormond (2018)
10.1016/B978-0-12-801419-6.00001-X
Brain Metastasis from Solid Tumors
Sami I. Bashour (2015)
10.1089/JPM.2013.0549
From Whole Brain to Hospice: Patterns of Care in Radiation Oncology
StavasMark (2014)
10.1684/BDC.2011.1335
Métastases cérébrales multiples d’un cancer du sein et leur prise en charge en radiothérapie : quelle est l’attitude thérapeutique la mieux adaptée ?
Y. Kirova (2011)
10.1158/1078-0432.CCR-06-2095
Treatment of Single Brain Metastasis with Resection, Intracavity Carmustine Polymer Wafers, and Radiation Therapy Is Safe and Provides Excellent Local Control
M. Ewend (2007)
10.1053/J.SEMINONCOL.2007.03.011
Surgical therapies in brain metastasis.
A. Kanner (2007)
10.1007/s00066-010-2100-y
DEGRO Practical Guidelines for Palliative Radiotherapy of Breast Cancer Patients: Brain Metastases and Leptomeningeal Carcinomatosis
P. Feyer (2010)
10.1093/ANNONC/MDL148
Dose-intensified bi-weekly temozolomide in patients with asymptomatic brain metastases from malignant melanoma: a phase II DeCOG/ADO study.
D. Schadendorf (2006)
10.3171/JNS.2006.105.3.375
Results of a phase II trial of the GliaSite radiation therapy system for the treatment of newly diagnosed, resected single brain metastases.
L. Rogers (2006)
10.1007/s13566-012-0052-9
Quality of life in patients with brain metastases receiving upfront as compared to salvage stereotactic radiosurgery using the EORTC QLQ-C15-PAL and the EORTC QLQ BN20 + 2: a pilot study
K. Koo (2012)
10.1016/S0360-3016(99)00416-2
Prognostic factors in brain metastases: should patients be selected for aggressive treatment according to recursive partitioning analysis (RPA) classes?
C. Nieder (2000)
See more
Semantic Scholar Logo Some data provided by SemanticScholar