The effectiveness of brain metastases radiotherapy in patients with melanoma

Introduction. Melanoma gives rise to 7–13% brain metastases (MBM — melanoma brain metastases) and is ranked third leading cause of brain metastases. The prognosis of patients with MBM is poor, with a median survival time of 3–6 months. Assessment of the value and limitations of three prognostic scores used in patients with melanoma brain metastases (MBM) was presented in this paper. Material and methods. In 110 patients with MBM, we executed an analysis of prognostic factors. All patients were treated with radiotherapy: whole brain radiotherapy performed as a treatment method in combination with chemotherapy (14 patients — 12.7%), neurosurgery (12 patients — 10.9% or stereotactic radiosurgery (8 patients — 7.3%). Results. The median overall survival (OS) from diagnosis MBM was 4.8 months (95% CI 4.1–5.2 months). The analyses showed that the Karnofsky Performance Status and number of the MBM are independent significant prognostic factors. The analyses of OS, as a function of prognostic scores, showed that in the class with the best prognosis median OS was similar (7.2–10.7 months); and in the class with the worse prognosis median OS was also similar (range, 2.6–4.3 months). Conclusions. Our observations and data from literature showed that the presented scores can: distinguish classes of patients by prognosis before treatment, guide the choice of treatment methods and help design strategies for patient selection in clinical trials but they did not fully discriminate between unfavourable groups.