World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Original Article

Volume 4, Number 1, February 2013, pages 37-45

Outcome Improvement in RPA I or II Patients With 1 or 2 Brain Metastases by Combined Surgery and Radiotherapy

**Table 1.** Patient Characteristics
Characteristic	Value	P
KPS: karnofsky performance status; BM: brain metastases; ECM: extracranial metastases; RPA: recursive partitioning analysis; GI: gastrointestinal; RCC: renal cell carcinoma.
Age (y)				0.02
Median	61.4 (20.9 - 86.2)	58.5 (38.6 - 78.3)	63.8 (20.9 - 86.2)
Gender (n)				0.8
Male	223 (67.8)	59 (56.7)	164 (72.9)
Female	106 (32.2)	45 (43.3)	61 (27.1)
KPS (n)				0.61
70 - 80	203 (61.7)	50 (48.1)	153 (68.0)
90 - 100	126 (38.3)	54 (51.9)	72 (32.0)
BM (n)				0.9
1	227 (69.0)	94 (90.4)	133 (59.1)
2	102 (31.0)	10 (9.6)	92 (40.9)
ECM (n)				0.9
Yes	217 (66.0)	47 (45.2)	170 (75.6)
No	112 (34.0)	57 (54.8)	55 (24.4)
Number of ECM (n)				0.33
1	101 (46.5)	33 (70.2)	68 (40.0)
≥ 2	116 (53.5)	14 (29.8)	102 (60.0)
Control of primary tumor (n)				0.9
Yes	141 (42.9)	54 (51.9)	87 (38.7)
No	188 (57.1)	50 (48.1)	138 (61.3)
Neurological symptoms (n)				0.86
Yes	204 (62.0)	82 (78.8)	122 (54.2)
No	125 (38.0)	22 (21.2)	103 (45.8)
Boost (n)				0.28
Yes	242 (73.6)	95 (91.4)	147 (65.3)
No	87 (26.4)	9 (8.6)	78 (34.7)
RPA (n)				0.75
Class I	63 (19.1)	46 (44.2)	17 (7.6)
Class II	266 (80.9)	58 (55.8)	208 (92.4)
Site of primary tumor (n)				0.002
Lung	205 (62.3)	56 (53.8)	149 (66.2)
Breast	33 (10.0)	13 (12.5)	20 (8.9)
Melanoma	20 (6.1)	9 (8.7)	11 (4.9)
GI	27 (8.2)	10 (9.6)	17 (7.6)
RCC	16 (4.9)	9 (8.7)	7 (3.1)
Other	28 (8.5)	7 (6.7)	21 (9.3)

Table 1. Patient Characteristics

Characteristic

Value

Entire series (n = 329) No (%)

Surgical group (n = 104) No (%)

Radiation group (n = 225) No (%)

KPS: karnofsky performance status; BM: brain metastases; ECM: extracranial metastases; RPA: recursive partitioning analysis; GI: gastrointestinal; RCC: renal cell carcinoma.

Age (y)

0.02

Median

61.4 (20.9 - 86.2)

58.5 (38.6 - 78.3)

63.8 (20.9 - 86.2)

Gender (n)

0.8

Male

223 (67.8)

59 (56.7)

164 (72.9)

Female

106 (32.2)

45 (43.3)

61 (27.1)

KPS (n)

0.61

70 - 80

203 (61.7)

50 (48.1)

153 (68.0)

90 - 100

126 (38.3)

54 (51.9)

72 (32.0)

BM (n)

0.9

227 (69.0)

94 (90.4)

133 (59.1)

102 (31.0)

10 (9.6)

92 (40.9)

ECM (n)

0.9

Yes

217 (66.0)

47 (45.2)

170 (75.6)

112 (34.0)

57 (54.8)

55 (24.4)

Number of ECM (n)

0.33

101 (46.5)

33 (70.2)

68 (40.0)

≥ 2

116 (53.5)

14 (29.8)

102 (60.0)

Control of primary tumor (n)

0.9

Yes

141 (42.9)

54 (51.9)

87 (38.7)

188 (57.1)

50 (48.1)

138 (61.3)

Neurological symptoms (n)

0.86

Yes

204 (62.0)

82 (78.8)

122 (54.2)

125 (38.0)

22 (21.2)

103 (45.8)

Boost (n)

0.28

Yes

242 (73.6)

95 (91.4)

147 (65.3)

87 (26.4)

9 (8.6)

78 (34.7)

RPA (n)

0.75

Class I

63 (19.1)

46 (44.2)

17 (7.6)

Class II

266 (80.9)

58 (55.8)

208 (92.4)

Site of primary tumor (n)

0.002

Lung

205 (62.3)

56 (53.8)

149 (66.2)

Breast

33 (10.0)

13 (12.5)

20 (8.9)

Melanoma

20 (6.1)

9 (8.7)

11 (4.9)

27 (8.2)

10 (9.6)

17 (7.6)

RCC

16 (4.9)

9 (8.7)

7 (3.1)

Other

28 (8.5)

7 (6.7)

21 (9.3)

**Table 2.** Results of Local Control, Brain Control and Overall Survival of the 2 Treatment Groups
	At 6 months (%)	At 12 months (%)	At 18 months (%)	At 24 months (%)	At 36 months (%)	P
Local control
Surgical group	92.7	91.1	91.1	91.1	83.9	0.005
Radiation group	88.9	81.2	72.6	63.1	57.3
Brain control
Surgical group	87	73.2	68.9	66.9	56	0.2
Radiation group	86.2	75.7	63	49.6	42.4
Overall survival
Surgical group	75.7	62.1	52.5	46.5	32	< 0.0001
Radiation group	45.6	27.1	17.8	10.5	6.1

Table 2. Results of Local Control, Brain Control and Overall Survival of the 2 Treatment Groups

At 6 months (%)

At 12 months (%)

At 18 months (%)

At 24 months (%)

At 36 months (%)

Local control

Surgical group

92.7

91.1

83.9

0.005

Radiation group

88.9

81.2

72.6

63.1

57.3

Brain control

Surgical group

73.2

68.9

66.9

0.2

Radiation group

86.2

75.7

49.6

42.4

Overall survival

Surgical group

75.7

62.1

52.5

46.5

< 0.0001

Radiation group

45.6

27.1

17.8

10.5

6.1

**Table 3.** Brain, Local and Regional Recurrences According to Treatment
	Brain recurrence n	Local recurrence n (%)	Regional recurrence n (%)	Both n (%)	Unknown n (%)
Surgical group (n = 104)	35	7 (20)	25 (71.4)	3 (8.6)
Radiation group (n = 225)	47	22 (46.8)	15 (31.9)	9 (19.2)	1 (2.1)
Total (n = 329)	82	29 (35.4)	40 (48.8)	12 (14.6)	1 (1.2)

Table 3. Brain, Local and Regional Recurrences According to Treatment

Brain recurrence
n

Local recurrence
n (%)

Regional recurrence
n (%)

Both
n (%)

Unknown
n (%)

Surgical group (n = 104)

7 (20)

25 (71.4)

3 (8.6)

Radiation group (n = 225)

22 (46.8)

15 (31.9)

9 (19.2)

1 (2.1)

Total (n = 329)

29 (35.4)

40 (48.8)

12 (14.6)

1 (1.2)