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Prognostic Score Essay

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For about 30 years, researchers developed prognostic scores and searched for prognostic factors to predict outcomes for cancer patients. Each scoring system may help with treatment decision making and includes different tumor and patient parameters. Combs et al. [1] published the first prognostic score for re-irradiation in recurrent glioma including patient age, histology and the time between first and second radiotherapy (RT) as key factors. One of the main difficulties in establishing and validating a score is the fact of patient heterogeneity, such as various histologies, time intervals between primary and secondary RT, different target volume concepts, and different time points during the course of the disease. To validate the “Combs Prognostic Score” efficacy we recently analysed the significance using a different, independent and relatively homogeneous patient cohort [2]. Results showed that the “Combs …show more content…
Until today, no standard treatment has been defined in the case of high-grade glioma recurrence. Age at treatment, primary histology, target volume (PTV), Karnofsky Performance Score (KPS), re-resection, and the time between primary and re-RT are known to have an influence on outcome, however, different research groups generated varying results in terms of their significance [6-10]. Recent evaluations analyzed the prognostic impact of the O6-Methylguanin-DNA-Methyltransferase (MGMT)-promotor status [11], resection [12,13], and radiation dose [2]. MGMT-promotor methylation is one of the strongest predictors of outcome, however, methylation status might change between initial diagnosis and recurrence. Since tumor tissue is often not available at recurrence, the integration of molecular markers in such as prognostic score might limit the wide use in clinical routine

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