Evaluation of five survival scores in a cohort of elderly patients with cerebral metastasis from non-small cell lung cancer

Abstract

Background/Aim: Survival scores are important for treatment personalisation. A score for older patients with cerebral metastasis from non-small cell lung cancer (NSCLC) was generated. Patients and Methods: Dose-fractionation of whole-brain irradiation, age, gender, general condition, histology, count of cerebral lesions, extra-cerebral metastatic spread and time between NSCLC-diagnosis and whole-brain irradiation were analysed for survival in 285 patients. Independent prognostic characteristics were utilised for the score, which was compared against five others. Results: Based on general condition (p<0.001) and extra-cerebral spread (p=0.003), three groups were generated according to the score, 2 (n=49), 4-6 (n=206) and 7 (n=30) points. Positive predictive values (PPVs) to predict death ≤6 months and survival for ≥6 months were 100% and 52%, respectively. PPVs of other scores were 88-98% and 60-63%. Conclusion: The accuracy of the new score to predict death within ≤6 months was optimal, whereas its accuracy to predict survival for ≥6 months was lower when compared to the other low PPVs of existing scores.