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Nomogram prediction of survival in patients with brain metastases from hepatocellular carcinoma treated with whole-brain radiotherapy: a multicenter retrospective study

Title
Nomogram prediction of survival in patients with brain metastases from hepatocellular carcinoma treated with whole-brain radiotherapy: a multicenter retrospective study
Authors
Park, YoungheeKim, Kyung SuKim, KyuboChie, Eui KyuKim, Jin HoKim, Jae-SungKim, Tae HyunKim, Dae YongIl Jang, WonKim, Mi-SookKoo, Tae RyoolChang, Ah Ram
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2015
Journal Title
JOURNAL OF NEURO-ONCOLOGY
ISSN
0167-594XJCR Link

1573-7373JCR Link
Citation
JOURNAL OF NEURO-ONCOLOGY vol. 125, no. 2, pp. 377 - 383
Keywords
Brain metastasisHepatocellular carcinomaPrognostic factorNomogram
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
The incidence of brain metastasis from hepatocellular carcinoma (HCC) is increasing because of the improved survival outcome of HCC patients, but the prognosis of these patients is extremely poor. HCC patients with brain metastasis were investigated to identify their prognostic factors for overall survival. Patients with brain metastasis from HCC who had been treated with whole-brain radiotherapy (WBRT) in five hospitals were enrolled in the study. The medical records of the patients were reviewed, and the clinical factors were analyzed to identify the prognostic factors for overall survival. Of the total of 97 patients who were enrolled in the study, 83 were male and the median age at the brain metastases was 56.6 years. Motor weakness (43.3 %) and headache (41.2 %) were common presenting symptoms. The median AFP level was 4180 ng/ml, and 81 patients were assessed as belonging to Child-Pugh classification A upon the diagnosis of brain metastasis. WBRT alone in 71 patients, surgery or radiosurgery combined with WBRT as the adjuvant setting in 18 patients, and WBRT as salvage treatment in 8 patients were performed. The median overall survival of the patients was 3.5 months. In the multivariate analysis, the ECOG performance status (PS), Child-Pugh classification, AFP, and treatment aim showed significant association with the overall survival of the patients. Based on these factors, a nomogram predicting the prognosis was developed. The concordance index of the nomogram was 0.74, and the prediction was well calibrated. In conclusion, the survival outcome of patients with brain metastasis from HCC can be predicted with the nomogram constructed from the ECOG PS, Child-Pugh classification, AFP, and treatment aim.
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DOI
10.1007/s11060-015-1926-7
Appears in Collections:
의과대학 > 의학과 > Journal papers
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