Recursive Partition Analysis

Recusive partition analysis is divided into several subsets for intracranial disease: Primary high grade CNS tumors ± temozolamide, Primary lower grade CNS tumors, and metastases. A newer metastatic profile garners more diagnostic information and establishes a more details prognostic assessment.

Metastatic Disease

The RPA looks at age, performance status and control of extra-cranial disease and broadly divides patients into three classes based on these characteristics.

Recursive Partition Analysis Brain Metastases
RPA ClassCharacteristicsMedian Survival
IAge < 65, KPS ≥ 70, Primary controlled7.1 months
IIAnyone not in Class I or III4.2 months
IIIKPS <702.6 months

Graded Prognostic Assessment

Unlike the RPA, the GPA assigns a score to a gradient of prognostic features: age, performance status, number of CNS metastases and presence or absence of extracranial metastases. This is scored as follows:

Graded Prognostic Assessment
MeasureScore
00.51.0
Age> 6050-59< 50
KPS< 7070-80≥ 90
No. of extracranial mets> 32-31
Extracranial metsPresent Absent

From this table a sum of the scores is created and prognosis is determined from these scores.

GPA score 0-1 MS 2.6 months
GPA score 1.5 - 2.5 MS 3.8 months
GPA score 3.0 MS 6.9 months
GPA score 3.5-4.0 MS 11 months