Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Partl, R; Fastner, G; Kaiser, J; Kronhuber, E; Cetin-Strohmer, K; Steffal, C; Böhmer-Breitfelder, B; Mayer, J; Avian, A; Berghold, A.
KPS/LDH index: a simple tool for identifying patients with metastatic melanoma who are unlikely to benefit from palliative whole brain radiotherapy.
Support Care Cancer. 2016; 24(2):523-528
Doi: 10.1007/s00520-015-2793-7
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- Führende Autor*innen der Med Uni Graz
- Partl Richard
- Co-Autor*innen der Med Uni Graz
- Avian Alexander
- Berghold Andrea
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- Abstract:
- Low Karnofsky performance status (KPS) and elevated lactate dehydrogenases (LDHs) as a surrogate marker for tumor load and cell turnover may depict patients with a very short life expectancy. To validate this finding and compare it to other indices, namely, the recursive partitioning analysis (RPA) and diagnosis-specific graded prognostic assessment (DS-GPA), a multicenter analysis was undertaken. A retrospective analysis of 234 metastatic melanoma patients uniformly treated with palliative whole brain radiotherapy (WBRT) was done. Univariate and multivariate analyses were used to determine the impact of patient-, tumor-, and treatment-related parameters on overall survival (OS). KPS and LDH emerged as independent factors predicting OS. By combining KPS and LDH values (KPS/LDH index), groups of patients with statistically significant differences in median OS (days; 95 % CI) after onset of WBRT were identified: group 1 (KPS ≥ 70/normal LDH) 234 (96-372), group 2 (KPS ≥ 70/elevated LDH) 112 (69-155), group 3 (KPS <70/normal LDH) 43 (12-74), and group 4 (KPS <70/elevated LDH) 29 (17-41). Between all four groups, statistically significant differences were observed. The RPA and DS-GPA indices failed to distinguish significantly between good and moderate prognosis and were inferior in predicting a very unfavorable prognosis. The parameters KPS and LDH independently impacted on OS. The combination of both (KPS/LDH index) identified patients with a very short life expectancy, who might be better served by recommending best supportive care instead of WBRT. The KPS/LDH index is simple and effective in terms of time and cost as compared to other prognostic indices.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Biomarkers, Tumor - metabolism
- Brain - pathology
- Brain Neoplasms - prevention & control
- Brain Neoplasms - radiotherapy
- Brain Neoplasms - secondary
- Female -
- Humans -
- Karnofsky Performance Status -
- Lactate Dehydrogenases - metabolism
- Male -
- Melanoma - pathology
- Melanoma - radiotherapy
- Middle Aged -
- Multivariate Analysis -
- Prognosis -
- Retrospective Studies -
- Tumor Burden -
- Young Adult -
- Find related publications in this database (Keywords)
- Melanoma
- LDH
- Brain metastasis
- WBRT
- Prognostic score