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Graded Prognostic Assessment (GPA) for Brain Metastases

The GPA is a validated prognostic index that estimates survival in patients with brain metastases using four clinical factors, developed from analysis of 1,960 patients in five RTOG trials.

Purpose:
Estimate median survival in brain metastases patients to guide treatment decisions
Population:
Patients with newly diagnosed brain metastases from any primary tumour
Factors:
Age, Karnofsky Performance Status (KPS), Number of brain metastases, Extracranial metastases
Reference:
Sperduto et al., JCO 2008
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GPA (Graded Prognostic Assessment)

Clinical Context & Background

The Graded Prognostic Assessment (GPA) is a prognostic index for patients with brain metastases. It is considered more accurate than the RPA as it is quantitative. Scores range from 0 (Poor) to 4 (Best). Note: This is the original GPA; specific DS-GPA (Diagnosis-Specific) nomograms exist for different primary sites.
Primary Source EvidenceSperduto PW, et al. A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database. Int J Radiat Oncol Biol Phys. 2008;70(2):510-514.
Formula Logic
Sum of scores (0, 0.5, 1.0) for Age, KPS, # of CNS Mets, and Extracranial Mets.

Reference Data

GPA ScoreMedian Survival
0 - 1.02.6 months
1.5 - 2.53.8 months
3.06.9 months
3.5 - 4.011.0 months

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