Whole brain radiotherapy for patients with brain metastasis from lung cancer – Prognostic significance of RTOG-RPA score

Background: Whole brain radiotherapy for patients with brain metastasis from lung cancer – prognostic significance of RTOG-RPA score. Aim: To evaluate the prognostic significance of Recursive partition Analysis (RPA) score in predicting the survival in patients with brain metastasis from Non-Small Cell Lung Cancer (NSCLC). Materials and methods: 35 patients diagnosed to have brain metastasis (BM) from primary NSCLC who had received palliative whole brain radiotherapy (WBRT) with or without chemotherapy from March 2014 to Mar 2017 were analyzed in this study. Data regarding the patient age, gender, performance status, histology, number of BM, time of metastasis, neurosurgical resection, radiotherapy details were collected and analyzed. Patients were divided into 3 groups according to RPA classification. The differences in clinical characteristics and treatment variables were analyzed by chi square test and overall survival analysis using Kaplan Mayer. The Cox proportional hazards regression model was used to determine statistically significant variables related to survival. Results: In univariate analysis histology, number of BM, extra cranial metastases, KPS and RPA score were identified to have prognostic significance. The result of multivariate analysis by the Cox proportional hazard model showed that RPA, no of mets and Extra cranial mets were significant. S. Jeeva, K. Chandralekha, V. Vanitha, M. Sornam, Balasubramanium, P. Vidya. Whole brain radiotherapy for patients with brain metastasis from lung cancer – Prognostic significance of RTOG-RPA score. IAIM, 2019; 6(5): 32-39. Page 33 Conclusions: Our study showed that RPA is good prognostic indicator in assessing the prognosis of patients with brain metastasis in NSCLC.

Down syndrome child with 48,XXY,+21 karyotype.

Cytogenetic analysis in 60 clinically suspected cases of Down syndrome and their parents was carried out using conventional Giemsa-trypsin-banding technique. Fifty-five individuals (91%) exhibited a free trisomy 21. Robertsonian translocations were seen in three cases and two cases exhibited a normal karyotype. A four-month-old child, the second-born of non-consanguineous parents, possessed an extra X chromosome in addition to trisomy 21. The proband's parents and his brother showed a normal karyotype. The phenotypic characteristics of this child have been discussed in the light of the published reports on double aneuploidies of XXY and trisomy 21.