A scoring tool to estimate the survival of elderly patients with brain metastases from esophageal cancer receiving whole-brain irradiation

Background/Aim: Elderly patients with metastatic esophageal cancer may benefit from individualized therapies. A tool to predict the survival of such patients with brain metastases was created. Patients and Methods: In 11 elderly patients (=65 years) receiving whole-brain irradiation (WBI) for brain metastases from esophageal cancer, age, gender, performance status, number of brain metastases, metastases outside the brain, time between cancer diagnosis and WBI, and WBI regimen were evaluated for survival. Results: On univariate analyses, age =73 years (p=0.046) and time between diagnosis of esophageal cancer and WBI =6 months (p=0.046) were significantly associated with poorer survival. On multivariate analysis, both showed a trend. Based on these two factors, the following points were assigned: age =72 years=1 point, age =73 years=0 points; time between cancer diagnosis and WBI >6 months=1 point, and =6 months=0 points. Three prognostic groups were thus formed: 0, 1 and 2 points. Survival rates of these groups at 6 months were 0%, 0% and 40% (p=0.012), respectively. Conclusion: This new tool allows estimation of survival and treatment individualization in elderly patients irradiated for brain metastases from esophageal cancer.