title: Comparison of nine prognostic scores in patients with brain metastases of breast cancer receiving radiotherapy of the brain.
abstract: OBJECTIVE
  Several prognostic indices (PI) have been developed to stratify patients with brain metastases in groups with good or bad prognosis. The aim of our study was to compare nine prognostic scores for patients with brain metastases (BM) of breast cancer receiving radiotherapy.
  
  
  METHODS
  The clinical data of 139 breast cancer patients with BM were collected retrospectively. All patients were treated with cerebral radiotherapy or surgery followed by radiotherapy between January 2007 and December 2012. The prognostic value and accuracy of recursive partitioning analysis (RPA), RPA II, graded prognostic assessment (GPA), basic score for BM, Breast-RPA, Breast-GPA, Rades Score 2011, Germany Score and Breast Rades Score were assessed.
  
  
  RESULTS
  The median survival after BM diagnosis in our cohort was 14 months. The overall 6-month, 1-, 2- and 3-year survival rates were 49.6, 37.4, 20.9 and 13.7 %, respectively. Most of the PI were associated with OS, but univariate analysis favored GPA regarding OS. GPA was the most accurate score to identify patients with long (longer than 12 months) and Breast-GPA patients with short (<3 months) life expectancy.
  
  
  CONCLUSIONS
  GPA and Breast-GPA seem to be the most useful scores and perform better than other PI for breast cancer patients with BM receiving radiotherapy.
authors.affiliation: Department of Gynecology, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. e.laakmann@uke.de.
authors.forename: Elena
authors.initials: E
authors.lastname: Laakmann
authors.affiliation: Department of Gynecology, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. Kerstin.riecke@stud.uke.uni-hamburg.de.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Riecke
authors.affiliation: Department of Radiotherapy, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. y.goy@uke.de.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Goy
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. j.kersten@uke.de.|Department of Biometrics and Statistics, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. j.kersten@uke.de.
authors.forename: Jan F
authors.initials: JF
authors.lastname: Kersten
authors.affiliation: Department of Radiotherapy, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. kruell@uke.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Krüll
authors.affiliation: Department of Gynecology, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. v.mueller@uke.de.
authors.forename: Volkmar
authors.initials: V
authors.lastname: Müller
authors.affiliation: Department of Radiotherapy, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. cor.petersen@uke.de.
authors.forename: Cordula
authors.initials: C
authors.lastname: Petersen
authors.affiliation: Department of Gynecology, University Medical Center, Martinistrasse 52, 20246, Hamburg, Germany. iwitzel@uke.de.
authors.forename: Isabell
authors.initials: I
authors.lastname: Witzel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016371:Cranial Irradiation / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D017567:Karnofsky Performance Status; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
keywords: Brain metastases; Breast cancer; Prognostic score