Survival prediction in patients with gynecological cancer irradiated for brain metastases

Authors

  • Silje Skjelsvik Os Department of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medical Physics, Oslo University Hospital, Oslo, Norway
  • Kjersti Skipar Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Telemark Hospital Trust, Skien, Norway
  • Eva Skovlund Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  • Ivar Hompland Department of Oncology, Oslo University Hospital, Oslo, Norway
  • Taran Paulsen Hellebust Department of Medical Physics, Oslo University Hospital, Oslo, Norway
  • Marianne Grønlie Guren Department of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  • Kristina Lindemann Department of Gynecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  • Esten Søndrol Nakken Department of Oncology, Oslo University Hospital, Oslo, Norway

DOI:

https://doi.org/10.2340/1651-226X.2023.34899

Keywords:

radiotherapy, brain metastases, gynecological cancer, palliation, survival

Abstract

Background and purpose: This large population-based, retrospective, single-center study aimed to identify prognostic factors in patients with brain metastases (BM) from gynecological cancers.

Material and methods: One hundred and forty four patients with BM from gynecological cancer treated with radiotherapy (RT) were identified. Primary cancer diagnosis, age, performance status, number of BM, presence of extracranial disease, and type of BM treatment were assessed. Overall survival (OS) was calculated using the Kaplan–Meier method and the Cox proportional hazards regression model was used for multivariable analysis. A prognostic index (PI) was developed based on scores from independent predictors of OS.

Results: Median OS for the entire study population was 6.2 months. Forty per cent of patients died within 3 months after start of RT. Primary cancer with the origin in cervix or vulva (p = 0.001),  Eastern Cooperative Oncology Group (ECOG) 3–4 (p < 0.001), and the presence of extracranial disease (p = 0.001) were associated with significantly shorter OS. The developed PI based on these factors, categorized patients into three risk groups with a median OS of 13.5, 4.0, and 2.4 months for the good, intermediate, and poor prognosis group, respectively.

Interpretation: Patients with BM from gynecological cancers carry a poor prognosis. We identified prognostic factors and developed a scoring tool to select patients with better or worse prognosis. Patients in the high-risk group have a particular poor prognosis, and omission of RT could be considered.

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Published

2024-04-21

How to Cite

Os, S. S., Skipar, K., Skovlund, E., Hompland, I., Hellebust, T. P., Guren, M. G., Lindemann, K., & Nakken, E. S. (2024). Survival prediction in patients with gynecological cancer irradiated for brain metastases. Acta Oncologica, 63(1), 206–212. https://doi.org/10.2340/1651-226X.2023.34899

Issue

Vol. 63 (2024): Acta Oncologica

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Original article

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Copyright (c) 2023 Silje Skjelsvik Os, Kjersti Skipar, Eva Skovlund, Ivar Hompland, Taran Paulsen Hellebust, Marianne Grønlie Guren, Kristina Lindemann, Esten Søndrol Nakken

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This work is licensed under a Creative Commons Attribution 4.0 International License.