A Survival Score for Very Elderly Patients with Brain Metastases Assigned to Stereotactic Radiosurgery or Fractionated Stereotactic Radiotherapy

Background/Aim: Very elderly patients may benefit from individualized treatment. A survival score was created for patients aged 80+ receiving radiosurgery or fractionated stereotactic radiotherapy for 1-2 brain metastases. Patients and Methods: Thirteen patients were retrospectively evaluated. Characteristics showing significant associations with survival or trends were used for analysis. Prognostic groups were calculated from scoring points of these characteristics (0=worse, 1=better survival) added for each patient. Results: Survival was significantly associated with performance score (p=0.010). Trends were found for histology (p=0.066) and diameter of lesions (p=0.071). Three groups were created (0, 1-2, 3 points) with 6-month survival rates of 0%, 56%, and 100% (p=0.025). Positive predictive values (PPVs) to predict death ≤6 months were 100% with the new score vs. not available and 50% with previous scores; PPVs regarding survival ≥6 were 100% vs. 75% and 67%. Conclusion: Given its limitations, the score was more precise than previous tools and can serve for orientation in patients aged 80+.