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2015, Number 2

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Rev Cubana Neurol Neurocir 2015; 5 (2)

Prognostic factors in a patient with encephalic metastasis: multicenter survey

Caballero GJ, Cruz GO, Llantá AMC, Marinello GJJ, Casanella Saint-Blancard OA, Díaz MRM

Language: Spanish
References: 32
Page: 103-113
PDF size: 242.56 Kb.


ABSTRACT

Objective: To identify prognostic factors in the selection of therapeutic modalities in patients with brain metastases according to the criteria of a group of Cuban specialists.
Methods: It was carried out a descriptive study about prognostics factors related with selection of therapeutic modality in patients with brain metastases based in the application of a survey in a group of neurosurgeons, neurologists, radiotherapeutics and oncologists. It was estimate the graded of importance in the definition of therapeutic modality in a patient with brain metastases of the following factors: age, sex, Karnofsky scale punctuation, Glasgow scale punctuation, focal neurological deficit, histology, primary disease control, proliferative potential, number of brain metastases, moment of apparition, localization, mass effect, size, solidity, antecedents of steroid use and recursive partitional analysis.
Results: 73 professionals were interviewed (23 neurosurgeons, 26 oncologists, 12 radiotherapeutics, and 12 neurologists). The average of years of experience in the handling of patients with brain metastases was 14. 8. 79 % affirmed to have much, middle or some experience in the handled of these patients. In general, it was signaled the following factors within influent factors in the selection of a therapeutics modalities: Karnofsky scale punctuation, Glasgow scale punctuation, histology, number of brain metastases, localization, mass effect and size. It was large discrepancies according to the age and solidity.
Conclusions: The opinions about prognosis factors of patient with encephalic metastasis have differences between specialties, as well as among the members of oneself specialty. In some punctual cases they are not in correspondence with the current scientific approaches. The prognostic index in patient with encephalic metastasis should not be interpreted in an isolated way. The heterogeneity of these patients imposes the realization of individualized prognostic index for each histology subtype.


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