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. 2024 Jul 24:48:100820.
doi: 10.1016/j.ctro.2024.100820. eCollection 2024 Sep.

Validity test of small cell lung cancer (SCLC) graded prognostic assessment and proposal of a new index for patients with brain metastases from SCLC

Masaaki Yamamoto  1   2 , Toru Serizawa  3 , Yasunori Sato  4 , Yoshinori Higuchi  5 , Yasuhito Kikuchi  1 , Sonomi Sato  1
Affiliations

Validity test of small cell lung cancer (SCLC) graded prognostic assessment and proposal of a new index for patients with brain metastases from SCLC

Masaaki Yamamoto et al. Clin Transl Radiat Oncol. .

Abstract

Background and purpose: We performed a validity test of a recently-reported, small cell lung cancer (SCLC) graded prognostic assessment (GPA) system for SCLC patients with brain metastases (BMs). Thereafter, we created a new prognostic index, the SCLC Grade, for such patients.

Materials and methods: We studied 508 SCLC patients selected from among nearly 7000 consecutive patients undergoing gamma knife SRS for BMs since 1998.

Results: In the SCLC GPA, there were no median survival time (MST) differences among pairs of the neighboring subgroups. Therefore, the 508 patients were randomly divided into the two series, i.e., a test (340 patients) and a validity (168) series. In the test series, five factors were identified by univariable analyses as favoring longer survival (rounded lower 95 % CI of the HR was at least 1.3): Sex, Karnofsky Performance Status, tumor numbers, primary tumor status and extracerebral metastases. This new index is the sum of scores (0 and 1) of these five factors: SCLC-Grade 4-6 (score of 4, 5 or 6), 2-3 (2 or 3), and 0-1 (0 or 1). This new system showed highly statistically significant MST differences among subclasses. Next, this SCLC-Grade was applied to the verification series. Consistent results were obtained, i.e., there were highly statistically significant MST differences among subclasses.

Conclusions: Our validity test results for the SCLC GPA demonstrated this system to not precisely reflect the outcomes of SCLC patients with BMs. Our results suggest the herein-proposed SCLC-Grade to have superior prognostic value.

Keywords: Brain metastases; Prognostic grade; Radiosurgery; Small cell lung cancer.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Overall survivals based on small cell lung cancer (SCLC) graded prognostic assessment (GPA) MST; median survival time, CI; confidence interval, IQR; inter-quartile range, HR; hazard ratio, SRS; stereotactic radiosurgery.
Fig. 2
Fig. 2
Overall survival based on small cell lung cancer (SCLC) grade in the two series, i.e., test (A) and verification (B) series. MST; median survival time, CI; confidence interval, IQR; inter-quartile range, HR; hazard ratio, SRS; stereotactic radiosurgery.
Fig. 3
Fig. 3
Overall survival based on small cell lung cancer (SCLC) grade in the two series, i.e., the earlier (A, before June 2008) and the most recent (B, after July 2008) series. MST; median survival time, CI; confidence interval, IQR; inter-quartile range, HR; hazard ration, SRS; stereotactic radiosurgery.
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