Session Item

Brain Metastases Velocity (BMV) is a recently developed prognostic tool taking brain metastases occurrence dynamics into account. So far, there are three different BMV scores considering the velocity of first occurrence of brain metastases (initial BMV; iBMV) or the recurrence of brain metastases after brain-directed therapy (classical BMV; cBMV and volumetric BMV; vBMC). The aim of our study was to validate all three scores in a patient cohort treated for brain metastases with stereotactic radiotherapy.

We retrospectively evaluated medical records of 386 patients with BM disease receiving stereotactic radiation therapy between January 2014 and December 2019. iBMV, cBMV, and vBMV were calculated. Kaplan-Meier survival curves were used to compare overall survival (OS). 

After a median follow‐up of 14 months (interquartile range: 5 –31), 1 year survival rate was 53%. 183 patients received a minimum of two treatments and 33 at least three treatments (range: 1-7 courses). The iBMV (including all 386 patients; p = 0.75) and the vBMV (104 patients where brain metastases volume was available; p = 0.9) could not sufficiently stratify the patients into different risk groups. The cBMV determined for 183 patients with distant brain failure, was able to significantly separate the different risk groups regarding OS (p < 0.001). At baseline, univariate analysis revealed the extracranial metastatic disease status and GPA to be significant predictors for OS. At first distant brain failure (DBF) extracranial metastatic disease status, karnofsky performance status, GPA and RPA represented prognostic factors.

In this BM cohort treated homogeneously with stereotactic radiotherapy, only cBMV was able to separate the different risk groups. In general, cBMV may be a valuable tool to decide on salvage radiosurgery for patients with DBF.