Weltman et al developed the Score Index for Radiosurgery (SIR) for patients with brain metastases. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals in Sao Paulo, Brazil.
Patient selection: brain metastases, selected for stereotactic radiosurgery
Parameters:
(1) age in years
(2) Karnofsky Performance Status (KPS)
(3) status of primary extracranial cancer
(4) volume of the largest brain lesion
(5) number of brain metastases
Parameter
Finding
Points
age in years
>= 60 years of age
0
51 to 59 years of age
1
<= 50 years of age
2
KPS
<= 50
0
60 or 70
1
80 to 100
2
status of primary cancer
progressive
0
stable disease
1
partial remission
1
complete remission or no sign of disease
2
volume of largest brain lesion
> 13 mL
0
5 to 13 mL
1
< 5 mL
2
number of brain metastases
>= 3
0
2
1
1
2
where:
• 5 mL corresponds to a diameter of 2.1 cm
• 13 mL corresponds to a diameter of 3 cm
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the better the prognosis.
Total Score
Risk Group
Acturarial Median Survival
0 to 3
poor
2.9 months
4 to 7
intermediate
7 months
8 to 10
fair
31.4 months
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