Validation of the graded prognostic assessment index for patients with brain metastases

Acta Oncol. 2009;48(3):457-9. doi: 10.1080/02841860802342390.


Background: The purpose of this study is to evaluate the performance of the new "Graded Prognostic Assessment" (GPA) index, which recently was developed from data in the Radiation Therapy Oncology Group (RTOG) database, in patients with brain metastases treated outside of randomized clinical trials.

Material and methods: The authors analyzed 232 patients with brain metastases and assigned these patients to the four indices previously evaluated by the RTOG (recursive partitioning analysis class, Score Index for Radiosurgery, Basic Score for Brain Metastases, and GPA).

Results: The present data confirm the results of the RTOG analysis. Each of the four indices splits the data set into prognostically different groups. In the GPA groups, median survival was 10.3, 5.6, 3.5, and 1.9 months, respectively (p<0.01). In the RTOG analysis, these figures were 11.0, 6.9, 3.8, and 2.6 months, respectively.

Conclusion: These results confirm the validity of the GPA index in a patient population that most likely is more representative of the normal clinical situation than patients included in randomized trials.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms / pathology*
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Survival Rate