title: Validation of the graded prognostic assessment index for patients with brain metastases.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Medical Department, Radiation Oncology Unit, Nordlandssykehuset HF, Bodø, Norway.
authors.forename: Carsten
authors.initials: C
authors.lastname: Nieder
authors.forename: Kirsten
authors.initials: K
authors.lastname: Marienhagen
authors.forename: Hans
authors.initials: H
authors.lastname: Geinitz
authors.forename: Michael
authors.initials: M
authors.lastname: Molls
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate