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Partl, R; Richtig, E; Avian, A; Berghold, A; Kapp, KS.
Karnofsky performance status and lactate dehydrogenase predict the benefit of palliative whole-brain irradiation in patients with advanced intra- and extracranial metastases from malignant melanoma.
Int J Radiat Oncol Biol Phys. 2013; 85(3):662-666 Doi: 10.1016/j.ijrobp.2012.06.009
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Führende Autor*innen der Med Uni Graz
Partl Richard
Co-Autor*innen der Med Uni Graz
Avian Alexander
Berghold Andrea
Kapp Karin S.
Richtig Erika
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Abstract:
To determine prognostic factors that allow the selection of melanoma patients with advanced intra- and extracerebral metastatic disease for palliative whole-brain radiation therapy (WBRT) or best supportive care. This was a retrospective study of 87 patients who underwent palliative WBRT between 1988 and 2009 for progressive or multiple cerebral metastases at presentation. Uni- and multivariate analysis took into account the following patient- and tumor-associated factors: gender and age, Karnofsky performance status (KPS), neurologic symptoms, serum lactate dehydrogenase (LDH) level, number of intracranial metastases, previous resection or stereotactic radiosurgery of brain metastases, number of extracranial metastasis sites, and local recurrences as well as regional lymph node metastases at the time of WBRT. In univariate analysis, KPS, LDH, number of intracranial metastases, and neurologic symptoms had a significant influence on overall survival. In multivariate survival analysis, KPS and LDH remained as significant prognostic factors, with hazard ratios of 3.3 (95% confidence interval [CI] 1.6-6.5) and 2.8 (95% CI 1.6-4.9), respectively. Patients with KPS ≥70 and LDH ≤240 U/L had a median survival of 191 days; patients with KPS ≥70 and LDH >240 U/L, 96 days; patients with KPS <70 and LDH ≤240 U/L, 47 days; and patients with KPS <70 and LDH >240 U/L, only 34 days. Karnofsky performance status and serum LDH values indicate whether patients with advanced intra- and extracranial tumor manifestations are candidates for palliative WBRT or best supportive care. Copyright © 2013 Elsevier Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Aged, 80 and over -
Analysis of Variance -
Biomarkers, Tumor - blood
Brain Neoplasms - enzymology
Brain Neoplasms - radiotherapy
Brain Neoplasms - secondary
Cranial Irradiation - methods
Female -
Humans -
Karnofsky Performance Status -
L-Lactate Dehydrogenase - blood
Male -
Melanoma - enzymology
Melanoma - radiotherapy
Melanoma - secondary
Middle Aged -
Palliative Care - methods
Retrospective Studies -
Tumor Burden -
Young Adult -

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