A new survival score for patients with brain metastases who received whole-brain radiotherapy (WBRT) alone

Background and purpose: Survival scores for patients with brain metastasis exist. However, the treatment regimens used to create these scores were heterogeneous. This study aimed to develop and validate a survival score in homogeneously treated patients.

Materials and methods: Eight-hundred-and-eighty-two patients receiving 10 × 3Gy of WBRT alone were randomly assigned to a test group (N=441) or a validation group (N=441). In the multivariate analysis of the test group, age, performance status, extracranial metastasis, and systemic treatment prior to WBRT were independent predictors of survival. The score for each factor was determined by dividing the 6-month survival rate (in %) by 10. Scores were summed and total scores ranged from 6 to 19 points. Patients were divided into four prognostic groups.

Results: The 6-month survival rates were 4% for 6-9 points, 29% for 10-14 points, 62% for 15-17 points, and 93% for 17-18 points (p<0.001) in the test group. The survival rates were 3%, 28%, 54% and 96%, respectively (p<0.001) in the validation group.

Conclusions: Since the 6-month survival rates in the validation group were very similar to the test group, this new score (WBRT-30) appears valid and reproducible. It can help making treatment choices and stratifying patients in future trials.