A tool to predict the probability of intracerebral recurrence or new cerebral metastases after whole-brain irradiation in patients with head-and-neck cancer

Background/Aim: Patients with metastatic head- and-neck cancer require individual therapies facilitated by prognostic tools. A tool to estimate the risk of recurrent or new cerebral metastases following whole-brain irradiation (WBI) is presented. Patients and Methods: Age, gender, performance status, cancer site, number of cerebral lesions, extracerebral metastases, and time between cancer diagnosis and treatment of cerebral metastases were evaluated for intracerebral control in 23 patients. For characteristics showing a trend (p<0.07), points for these characteristics were created by dividing 6-month intracerebral control rates by 10. Patient scores were obtained by adding these points. Results: Better intracerebral control was significantly associated with oropharyngeal and laryngeal cancer (p=0.014). Absence of extra-cerebral metastases (p=0.069) and longer time between cancer diagnosis and treatment of cerebral metastases (p=0.053) showed trends. Three groups were identified, namely with 3-11, 13-18 and 20-24 points. Six-month intracerebral control rates were 0%, 50% and 100% (p=0.003), respectively, for these groups. Conclusion: A new tool was created to predict intracerebral control following WBI and should contribute to personalization of treatment for patients with cerebral metastases of head-and-neck cancer.