Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit

Background: Brain metastases are relatively common and carry a poor prognosis. In a resource-constrained environment, the judicious use of radiotherapy must be considered in the context of its benefit. The Recursive Partitioning Analysis (RPA) scoring system is internationally validated to predict m...

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Autores principales:	Presha Bipath, Laura W. Stopforth, Santuri Naicker, Poovandren Govender, Wilbert Sibanda, Louise Walker
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	ain metastases recursive partitioning analysis whole brain radiotherapy prognostic scoring system Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/49b552505f31401fa2770c7f52719f93
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spelling	oai:doaj.org-article:49b552505f31401fa2770c7f52719f932021-11-24T07:48:47ZEstablishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit2518-87042523-064610.4102/sajo.v5i0.175https://doaj.org/article/49b552505f31401fa2770c7f52719f932021-11-01T00:00:00Zhttps://sajo.org.za/index.php/sajo/article/view/175https://doaj.org/toc/2518-8704https://doaj.org/toc/2523-0646Background: Brain metastases are relatively common and carry a poor prognosis. In a resource-constrained environment, the judicious use of radiotherapy must be considered in the context of its benefit. The Recursive Partitioning Analysis (RPA) scoring system is internationally validated to predict median survival in patients with brain metastases. It may be used to guide appropriate management of patients with brain metastases. Aim: To establish the relevance of applying the RPA prognostic scoring system to the local setting. Setting: The Department of Oncology, Greys Hospital, Pietermaritzburg, South Africa. Methods: A retrospective chart review of patients treated for brain metastases for the period 01 January 2014 to 31 December 2019 was performed. Data was collected to determine the RPA class for each patient. Multivariate analysis of potential factors which could impact survival was done, and the actual survival of each patient was calculated. Results: The commonest primary cancer in the study cohort was breast (67%), followed by lung (17%). Survival differences between RPA classes were statistically significant (p 0.001). Actual survival relative to that predicted by the RPA model was 4.5 versus 7–12 months, 3.6 versus 4–7 months, and 0.8 versus 2–4 months, for classes I, II and III, respectively. Conclusion: Results support the use of the RPA classification to risk stratify patients in this setting – and therefore may be used in treatment decision-making. However, it over-predicts the median survival for the local population. Larger studies are warranted in diagnostically homogenous patient groups with brain metastases, to determine survival more accurately.Presha BipathLaura W. StopforthSanturi NaickerPoovandren GovenderWilbert SibandaLouise WalkerAOSISarticleain metastasesrecursive partitioning analysiswhole brain radiotherapyprognostic scoring systemNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENSouth African Journal of Oncology, Vol 5, Iss 0, Pp e1-e6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ain metastases recursive partitioning analysis whole brain radiotherapy prognostic scoring system Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	ain metastases recursive partitioning analysis whole brain radiotherapy prognostic scoring system Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Presha Bipath Laura W. Stopforth Santuri Naicker Poovandren Govender Wilbert Sibanda Louise Walker Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit
description	Background: Brain metastases are relatively common and carry a poor prognosis. In a resource-constrained environment, the judicious use of radiotherapy must be considered in the context of its benefit. The Recursive Partitioning Analysis (RPA) scoring system is internationally validated to predict median survival in patients with brain metastases. It may be used to guide appropriate management of patients with brain metastases. Aim: To establish the relevance of applying the RPA prognostic scoring system to the local setting. Setting: The Department of Oncology, Greys Hospital, Pietermaritzburg, South Africa. Methods: A retrospective chart review of patients treated for brain metastases for the period 01 January 2014 to 31 December 2019 was performed. Data was collected to determine the RPA class for each patient. Multivariate analysis of potential factors which could impact survival was done, and the actual survival of each patient was calculated. Results: The commonest primary cancer in the study cohort was breast (67%), followed by lung (17%). Survival differences between RPA classes were statistically significant (p 0.001). Actual survival relative to that predicted by the RPA model was 4.5 versus 7–12 months, 3.6 versus 4–7 months, and 0.8 versus 2–4 months, for classes I, II and III, respectively. Conclusion: Results support the use of the RPA classification to risk stratify patients in this setting – and therefore may be used in treatment decision-making. However, it over-predicts the median survival for the local population. Larger studies are warranted in diagnostically homogenous patient groups with brain metastases, to determine survival more accurately.
format	article
author	Presha Bipath Laura W. Stopforth Santuri Naicker Poovandren Govender Wilbert Sibanda Louise Walker
author_facet	Presha Bipath Laura W. Stopforth Santuri Naicker Poovandren Govender Wilbert Sibanda Louise Walker
author_sort	Presha Bipath
title	Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit
title_short	Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit
title_full	Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit
title_fullStr	Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit
title_full_unstemmed	Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit
title_sort	establishing the utility of recursive partitioning analysis for patients with intra-cranial metastases managed in a kwazulu-natal state sector oncology unit
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/49b552505f31401fa2770c7f52719f93
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Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit

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