Journal article
The 5-factor modified frailty index as a prognostic factor of stereotactic radiosurgery for metastatic disease to the brain
Journal of neurosurgery, v 140(4), pp 929-937
01 Apr 2024
PMID: 37856413
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Frailty, a state of increased vulnerability to adverse health outcomes, is associated with poor neurosurgical outcomes. The relationship between frailty and stereotactic radiosurgery (SRS) for brain metastases (BMs), however, has not been adequately described. In this study, the authors attempted to examine the connection between frailty and outcomes for patients receiving SRS for BMs.
A single-center retrospective cohort study was performed. The 5-factor modified frailty index (mFI-5) was used to stratify patients into pre-frail (mFI-5 score 0-1), frail (mFI-5 score 2), and severely frail (mFI-5 score ≥ 3) cohorts at the time of SRS treatment. Both overall survival (OS) and progression-free survival (PFS) were evaluated. Factors associated with OS/PFS were assessed using Kaplan-Meier analysis and a Cox proportional hazards model.
Two hundred three patients met the inclusion criteria and received SRS to one or more BMs. Fifty-six patients (27.6%) received SRS as an adjuvant treatment. The 12-month OS and PFS rates were 58.6% and 45.5%, respectively. One hundred twenty-six patients (62.1%) were classified as pre-frail, 58 (28.6%) as frail, and 19 (9.4%) as severely frail. Significantly less OS was demonstrated in frailer groups (frail hazard ratio [HR] 3.14, p < 0.005; severely frail HR 3.13, p < 0.005). Compared with pre-frail patients, frail patients had shorter intervals of PFS (frail HR 2.05, p < 0.005). Five patients (2.5%) had symptomatic radiation necrosis (RN) and 60 (29.6%) required repeat radiation.
Higher frailty scores at the time of SRS treatment were predictive of shorter OS and PFS intervals.
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Details
- Title
- The 5-factor modified frailty index as a prognostic factor of stereotactic radiosurgery for metastatic disease to the brain
- Creators
- Thomas Lucido - Drexel UniversitySujay Rajkumar - Drexel UniversityBrandon Rogowski - Drexel UniversityJustin Meinert - Drexel UniversityShahed Elhamdani - Allegheny Health NetworkYun Liang - Allegheny Health NetworkStephen Karlovits - Allegheny Health NetworkAlexander Yu - Allegheny Health NetworkRodney E Wegner - Allegheny Health NetworkMatthew J Shepard - Allegheny Health Network
- Publication Details
- Journal of neurosurgery, v 140(4), pp 929-937
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:001229574800002
- Scopus ID
- 2-s2.0-85186433601
- Other Identifier
- 991022154807104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery