[Radiotherapy of brain metastases according to the GPA score (Graded Prognostic Assessment)]

Abstract

The management of patients with brain metastases remains a difficult and controversial subject. For years, the standard treatment has been whole-brain radiation therapy alone, but its validity is now under question because of improvements in surgery and the development of radiosurgery or novel targeted therapies and also because whole-brain radiation therapy is responsible for long term neurocognitive toxicity. Therefore it is important to assess diagnosis-specific prognostic factors and indexes when scheduling treatments. The GPA score (Graded Prognostic Assessment), established for various histologic tumor types, includes five prognostic factors: age, Karnofsky Performance Status, presence of extracranial metastases, number of brain metastases and also genetic subtype for breast cancer. We propose an adaptation of the management of brain metastases according to the GPA score.

Keywords: Brain metastases; GPA (Graded Prognostic Assessment); GPA score; Irradiation encéphalique en totalité; Métastases cérébrales; Radiosurgery; Radiothérapie en conditions stéréotaxiques; Whole brain radiation therapy.