title: Does Graded Prognostic Assessment outperform Recursive Partitioning Analysis in patients with moderate prognosis brain metastases?
abstract: OBJECTIVE
  To compare the clinical utility of the Recursive Partitioning Analysis (RPA) and Graded Prognostic Assessment (GPA) in predicting outcomes for moderate prognosis patients with brain metastases.
  
  
  METHODS
  We reviewed 101 whole brain radiotherapy cases. RPA and GPA were calculated. Overall survival was compared.
  
  
  RESULTS
  Sixty-eight patients had moderate prognosis. RPA patient characteristics for increased death hazard were ≤10 WBRT fractions or no surgery/radiosurgery. GPA patients had increased death risk with no surgery/radiosurgery or lower Karnofsky Performance Status.
  
  
  CONCLUSIONS
  The indices have similar predicted survival. Patients scored by RPA with longer radiation schedules had longer survival; patients scored by GPA did not. This indicates GPA is more clinically useful, leaving less room for subjective treatment choices.
authors.affiliation: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Neil C
authors.initials: NC
authors.lastname: Estabrook
authors.affiliation: Blanchard Valley Regional Cancer Center, Findlay, OH, USA.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Lutz
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Johnson
authors.affiliation: University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Lo
authors.affiliation: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Henderson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: brain metastasis; prognosis; radiotherapy