Independent Validation of a Unifying Prognostic Model for Intracranial and Extracranial Metastasis-directed Radiotherapy

Anticancer Res. 2023 Jul;43(7):3167-3172. doi: 10.21873/anticanres.16490.


Background/aim: The aim of this study was to analyze the validity of a unifying prognostic model, originally developed by Kowalchuk et al., because relevant variations in clinical practice and observed survival may impact on the performance of predictive tools.

Patients and methods: Retrospectively, data from a single institution were analyzed. The study included 253 patients managed with radiotherapy for spine and/or brain metastases. The Kowalchuk et al. score [3 parameters including performance status, number of organ systems involved with disease outside of the organ system of the treatment target, and treatment of intracranial target(s)] was assigned and the resulting prognostic strata compared.

Results: The decision tool developed by Kowalchuk et al. performed well, e.g., in terms of 2-year survival. Complementary information could be obtained by analyses of blood test results such as hemoglobin, albumin, and C-reactive protein.

Conclusion: The new unifying score emerged as a valid prognostic model in our external validation database.

Keywords: Prognostic model; brain metastases; metastatic cancer; overall survival; radiotherapy; spine metastases.

MeSH terms

  • Brain Neoplasms* / secondary
  • Humans
  • Prognosis
  • Retrospective Studies