Patient selection: meningeal carcinomatosis in a patient with breast cancer
Parameters:
(1) hormone receptor status
(2) WHO/ECOG performance status
(3) number of previous chemotherapy "lines" (probably courses)
(4) CSF concentration of Cyfra 21-1 (Cy =cytokeratin, fra = fragment, cytokeratin CK19 fragment)
|
Parameter
|
Finding
|
Points
|
|
hormone status
|
positive
|
0
|
|
|
negative
|
1
|
|
ECOG performance
|
0, 1 or 2
|
0
|
|
|
3 or 4
|
1
|
|
previous chemotherapy
|
<= 3
|
0
|
|
|
>= 4
|
1
|
|
Cyfra 21-1 in CSF
|
<= 4 ng/mL
|
0
|
|
|
> 4 ng/mL
|
1
|
where:
• Hormone status negative was not defined. Presumably negative for estrogen and progesterone receptors. This group would include triple negative tumors.
complete score =
= SUM(all 4 parameters)
simplified score =
= SUM(points for first 3 parameters without Cyfra-21)
Interpretation:
• minimum score: 0
• maximum complete score: 4
• maximum simplified score: 3
• The higher the score the worse the prognosis.
• A simplified score of 0 was associated with a 33% overall survival at 24 months. A simplified score of 1 had a 100% mortality at 15 months. A simplified score of 2 or 3 had a 100% mortality at 4 months.
