Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival
Abstract Overall survival (OS) of patients with brain metastases treated with hypofractionated (HFSRT) or single-fraction (SRS) radiosurgery depends on several prognostic factors. The aim of this study was to investigate the potential of sex as an independent predictor of OS and evaluate the predict...
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Nature Portfolio
2021
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oai:doaj.org-article:4da15b7ddcc345acb0eb45dab20cec912021-12-02T13:39:55ZHypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival10.1038/s41598-021-88070-52045-2322https://doaj.org/article/4da15b7ddcc345acb0eb45dab20cec912021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88070-5https://doaj.org/toc/2045-2322Abstract Overall survival (OS) of patients with brain metastases treated with hypofractionated (HFSRT) or single-fraction (SRS) radiosurgery depends on several prognostic factors. The aim of this study was to investigate the potential of sex as an independent predictor of OS and evaluate the predictive accuracy of common prognostic scores. Retrospective analysis of 281 consecutive patients receiving radiosurgery of brain metastases was performed. Kaplan–Meier survival curves and Cox proportional hazards models were used to compare OS between SRS and HFSRT and by sex, before and after propensity-score matching (PSM) on key baseline prognostic covariates. Prognostic scores were evaluated using Harrell’s concordance index. Median OS was 11 months after both SRS and HFSRT. After PSM, median OS was 12 months after SRS (95% CI: 7.5–16.5) and 9 months after HFSRT (95% CI: 5.0–13.0; p = 0.77). Independent prognostic factors were sex, primary tumor, KPI, and systemic disease status. Median OS was 16 months for women and 7 months for male patients (p < 0.001). After excluding sex specific tumors, PSM revealed a median OS of 16 months for women and 8 months for male patients (p < 0.01). Evaluation of prognostic indices showed BSBM to be the most accurate (Harrell’s C = 0.68), followed by SIR (0.61), GPA (0.60), RPA (0.58), and Rades et al. (0.57). OS after HFSRT and SRS did not differ, although PSM revealed a non-significant advantage for SRS. Female sex was found to be a major independent positive prognostic factor for survival, and thus should be considered in the personalized decision-making of brain metastases treatment.Julian MangesiusThomas SeppiKatie BatesChristoph R. ArnoldDanijela MinaschStephanie MangesiusJohannes KerschbaumerPeter LukasUte GanswindtMeinhard Nevinny-StickelNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021) |
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Medicine R Science Q Julian Mangesius Thomas Seppi Katie Bates Christoph R. Arnold Danijela Minasch Stephanie Mangesius Johannes Kerschbaumer Peter Lukas Ute Ganswindt Meinhard Nevinny-Stickel Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| description |
Abstract Overall survival (OS) of patients with brain metastases treated with hypofractionated (HFSRT) or single-fraction (SRS) radiosurgery depends on several prognostic factors. The aim of this study was to investigate the potential of sex as an independent predictor of OS and evaluate the predictive accuracy of common prognostic scores. Retrospective analysis of 281 consecutive patients receiving radiosurgery of brain metastases was performed. Kaplan–Meier survival curves and Cox proportional hazards models were used to compare OS between SRS and HFSRT and by sex, before and after propensity-score matching (PSM) on key baseline prognostic covariates. Prognostic scores were evaluated using Harrell’s concordance index. Median OS was 11 months after both SRS and HFSRT. After PSM, median OS was 12 months after SRS (95% CI: 7.5–16.5) and 9 months after HFSRT (95% CI: 5.0–13.0; p = 0.77). Independent prognostic factors were sex, primary tumor, KPI, and systemic disease status. Median OS was 16 months for women and 7 months for male patients (p < 0.001). After excluding sex specific tumors, PSM revealed a median OS of 16 months for women and 8 months for male patients (p < 0.01). Evaluation of prognostic indices showed BSBM to be the most accurate (Harrell’s C = 0.68), followed by SIR (0.61), GPA (0.60), RPA (0.58), and Rades et al. (0.57). OS after HFSRT and SRS did not differ, although PSM revealed a non-significant advantage for SRS. Female sex was found to be a major independent positive prognostic factor for survival, and thus should be considered in the personalized decision-making of brain metastases treatment. |
| format |
article |
| author |
Julian Mangesius Thomas Seppi Katie Bates Christoph R. Arnold Danijela Minasch Stephanie Mangesius Johannes Kerschbaumer Peter Lukas Ute Ganswindt Meinhard Nevinny-Stickel |
| author_facet |
Julian Mangesius Thomas Seppi Katie Bates Christoph R. Arnold Danijela Minasch Stephanie Mangesius Johannes Kerschbaumer Peter Lukas Ute Ganswindt Meinhard Nevinny-Stickel |
| author_sort |
Julian Mangesius |
| title |
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| title_short |
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| title_full |
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| title_fullStr |
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| title_full_unstemmed |
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| title_sort |
hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/4da15b7ddcc345acb0eb45dab20cec91 |
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