Development of a Survival Score for Patients with Cerebral Metastases from Melanoma

Abstract

Background/aim: To develop a survival score for patients receiving whole-brain irradiation (WBI) alone for cerebral metastases from melanoma.

Patients and methods: Forty-five patients who met the required criteria were included. WBI doses had to be >30 Gy. Six variables were analyzed: age, gender, Karnofsky performance score (KPS), number of cerebral metastases, extracranial metastatic spread and interval from diagnosis of melanoma until WBI. In order to estimate patients' survival scores, variables showing at least a trend (p<0.06) on multivariate analysis were considered. One point was assigned to each variable correlating with better survival rates and zero points to those correlating with worse survival rates.

Results: By multivariate analysis, age (p=0.002) achieved significance and KPS (p=0.056) showed a trend. Patients' survival scores were obtained by adding zero or one point from each variable and resulted in three groups of 0, 1 or 2 points. The median survival times of these groups were one, four and ten months (p<0.0001).

Conclusion: A survival score was developed for patients assigned to WBI alone for cerebral metastases from melanoma. This new instrument may facilitate the decision for the appropriate WBI-program.

Keywords: Survival score; cerebral metastases; melanoma; treatment selection; whole-brain irradiation.