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Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria
Background: Brain metastases (BM) are increasingly being treated using stereotactic radiosurgery (SRS). Standardized response criteria are necessary to improve research and treatment protocols. This study’s goal was to validate the RANO-BM criteria thresholds for tumor progression in a cohort of pat...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670467/ https://www.ncbi.nlm.nih.gov/pubmed/37999099 http://dx.doi.org/10.3390/curroncol30110679 |
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author | Douri, Keiss Iorio-Morin, Christian Mercure-Cyr, Rosalie Figueiredo, Gabrielle Touchette, Charles Jean Masson-Côté, Laurence Mathieu, David |
author_facet | Douri, Keiss Iorio-Morin, Christian Mercure-Cyr, Rosalie Figueiredo, Gabrielle Touchette, Charles Jean Masson-Côté, Laurence Mathieu, David |
author_sort | Douri, Keiss |
collection | PubMed |
description | Background: Brain metastases (BM) are increasingly being treated using stereotactic radiosurgery (SRS). Standardized response criteria are necessary to improve research and treatment protocols. This study’s goal was to validate the RANO-BM criteria thresholds for tumor progression in a cohort of patients with brain metastases managed using SRS. Methods: We performed a retrospective analysis of patients treated at least twice with SRS for brain metastases. Local progression, as defined by RANO-BM criteria, was compared to our multidisciplinary tumor board’s treatment recommendation. A ROC curve was generated using varying diameter thresholds to assess the sensitivity and specificity of current RANO-BM criteria. Results: 249 metastases in 67 patients were included in the analysis. RANO-BM criteria current progression thresholds yielded a sensitivity of 38%, a specificity of 95%, a positive predictive value of 71%, and a negative predictive value of 84% relative to our tumor board’s treatment recommendation. Modified RANO-BM criteria using absolute diameter differences of 2.5 mm yielded a sensitivity of 83%, a specificity of 87%, a positive predictive value of 67% and a negative predictive value of 94%. Conclusions: Current RANO-BM criteria unreliably identifies clinically relevant tumor progression. The use of absolute diameter differences thresholds appears superior in our BM cohort. |
format | Online Article Text |
id | pubmed-10670467 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106704672023-10-24 Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria Douri, Keiss Iorio-Morin, Christian Mercure-Cyr, Rosalie Figueiredo, Gabrielle Touchette, Charles Jean Masson-Côté, Laurence Mathieu, David Curr Oncol Article Background: Brain metastases (BM) are increasingly being treated using stereotactic radiosurgery (SRS). Standardized response criteria are necessary to improve research and treatment protocols. This study’s goal was to validate the RANO-BM criteria thresholds for tumor progression in a cohort of patients with brain metastases managed using SRS. Methods: We performed a retrospective analysis of patients treated at least twice with SRS for brain metastases. Local progression, as defined by RANO-BM criteria, was compared to our multidisciplinary tumor board’s treatment recommendation. A ROC curve was generated using varying diameter thresholds to assess the sensitivity and specificity of current RANO-BM criteria. Results: 249 metastases in 67 patients were included in the analysis. RANO-BM criteria current progression thresholds yielded a sensitivity of 38%, a specificity of 95%, a positive predictive value of 71%, and a negative predictive value of 84% relative to our tumor board’s treatment recommendation. Modified RANO-BM criteria using absolute diameter differences of 2.5 mm yielded a sensitivity of 83%, a specificity of 87%, a positive predictive value of 67% and a negative predictive value of 94%. Conclusions: Current RANO-BM criteria unreliably identifies clinically relevant tumor progression. The use of absolute diameter differences thresholds appears superior in our BM cohort. MDPI 2023-10-24 /pmc/articles/PMC10670467/ /pubmed/37999099 http://dx.doi.org/10.3390/curroncol30110679 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Douri, Keiss Iorio-Morin, Christian Mercure-Cyr, Rosalie Figueiredo, Gabrielle Touchette, Charles Jean Masson-Côté, Laurence Mathieu, David Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria |
title | Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria |
title_full | Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria |
title_fullStr | Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria |
title_full_unstemmed | Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria |
title_short | Response Assessment in Brain Metastases Managed by Stereotactic Radiosurgery: A Reappraisal of the RANO-BM Criteria |
title_sort | response assessment in brain metastases managed by stereotactic radiosurgery: a reappraisal of the rano-bm criteria |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670467/ https://www.ncbi.nlm.nih.gov/pubmed/37999099 http://dx.doi.org/10.3390/curroncol30110679 |
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