| dc.contributor.author | Cameron, Brent | |
| dc.contributor.author | Attia, Albert | |
| dc.date.accessioned | 2020-04-27T16:31:50Z | |
| dc.date.available | 2020-04-27T16:31:50Z | |
| dc.date.issued | 2019-09 | |
| dc.identifier.citation | Sperduto, P. W., Fang, P., Li, J., Breen, W., Brown, P. D., Cagney, D., Aizer, A., Yu, J. B., Chiang, V., Jain, S., Gaspar, L. E., Myrehaug, S., Sahgal, A., Braunstein, S., Sneed, P., Cameron, B., Attia, A., Molitoris, J., Wu, C. C., Wang, T., … Mehta, M. P. (2019). Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA). Clinical and translational radiation oncology, 18, 39–45. https://doi.org/10.1016/j.ctro.2019.06.007 | en_US |
| dc.identifier.other | eISSN 2405-6308 | |
| dc.identifier.uri | http://hdl.handle.net/1803/9963 | |
| dc.description | Only Vanderbilt University affiliated authors are listed on VUIR. For a full list of authors, access the version of record at https://www.sciencedirect.com/science/article/pii/S2405630819300539 | en_US |
| dc.description.abstract | Background: Patients with gastrointestinal cancers and brain metastases (BM) represent a unique and heterogeneous population. Our group previously published the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with GI cancers (GI-GPA) (1985-2007, n = 209). The purpose of this study is to update the GI-GPA based on a larger contemporary database.
Methods: An IRB-approved consortium database analysis was performed using a multi-institutional (18), multi-national (3) cohort of 792 patients with gastrointestinal (GI) cancers, with newly-diagnosed BM diagnosed between 1/1/2006 and 12/31/2017. Survival was measured from date of first treatment for BM. Multiple Cox regression was used to select and weight prognostic factors in proportion to their hazard ratios. These factors were incorporated into the updated GI-GPA.
Results: Median survival (MS) varied widely by primary site and other prognostic factors. Four significant factors (KPS, age, extracranial metastases and number of BM) were used to formulate the updated GI-GPA. Overall MS for this cohort remains poor; 8 months. MS by GPA was 3, 7, 11 and 17 months for GPA 0-1, 1.5-2, 2.5-3.0 and 3.5-4.0, respectively. >30% present in the worst prognostic group (GI-GPA of <= 1.0).
Conclusions: Brain metastases are not uncommon in GI cancer patients and MS varies widely among them. This updated GI-GPA index improves our ability to estimate survival for these patients and will be useful for therapy selection, end-of-life decision-making and stratification for future clinical trials. A user-friendly, free, on-line app to calculate the GPA score and estimate survival for an individual patient is available at brainmetgpa.com. (C) 2019 Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology. | en_US |
| dc.description.sponsorship | Grant Support: 1) National Institutes of Health (NIH) grant number UL1TR002494 from the National Center for Advancing Translational Sciences (NCATS). Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Minnesota. 2) NIH grant number P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and the NCATS. The design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication was solely the responsibility of the authors and does not necessarily represent the official views of the Funders/Sponsors (National Center for Research Resources or the NIH). | en_US |
| dc.language.iso | en_US | en_US |
| dc.publisher | Clinical and Translational Radiation Oncology | en_US |
| dc.rights | https://doi.org/10.1016/j.ctro.2019.06.007
2405-6308/ 2019 Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). | |
| dc.subject | Gastrointestinal cancers | en_US |
| dc.subject | Brain metastases | en_US |
| dc.subject | Prognosis | en_US |
| dc.subject | End-of-life | en_US |
| dc.title | Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA) | en_US |
| dc.type | Article | en_US |
| dc.identifier.doi | 10.1016/j.ctro.2019.06.007 | |
