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Clinical calculator summary

RPA Classification for Brain Metastases

The Radiation Therapy Oncology Group (RTOG) Recursive Partitioning Analysis classifies brain metastases patients into three prognostic classes based on clinical factors.

Evidence-based context for fast calculator use

Purpose:
Rapidly classify brain metastases patients into prognostic groups (Class I, II, or III)
Population:
Patients with brain metastases being considered for radiation therapy
Factors:
Age, Karnofsky Performance Status (KPS), Primary tumour status, Extracranial metastases
Reference:
Gaspar et al., IJROBP 1997
HomeRPA (Brain Metastases)
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RPA (Brain Metastases)

years

Clinical Context & Background

The Radiation Therapy Oncology Group (RTOG) Recursive Partitioning Analysis (RPA) classifies patients with brain metastases into three prognostic classes based on age, Karnofsky Performance Status (KPS), control of primary tumor, and presence of extracranial metastases.
Primary Source EvidenceGaspar L, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys. 1997;37(4):745-751.
Formula Logic
Classification logic based on Age, KPS, Primary Control, and Extracranial Mets.

Reference Data

RPA ClassCriteriaMedian Survival
Class IAge < 65, KPS ≥ 70, Primary controlled, No extracranial mets7.1 months
Class IIAll others4.2 months
Class IIIKPS < 702.3 months

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use RPA (Brain Metastases) when rTOG RPA classifies brain metastases patients into prognostic groups by age, KPS, and disease status to guide radiation treatment planning.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning Class I through Class III.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Confirm primary histology, molecular classification, number and location of lesions, extracranial disease, performance status, and treatment era.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Generic brain-metastasis and disease-specific GPA models should not be interchanged.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients with primary or metastatic central nervous system disease in the setting described by the model

How to apply this result

For a representative case, verify Karnofsky Performance Status, Age, Primary Tumor Status, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

Neuro-Oncology hubContinue to related calculators and clinical workflow resources.

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Related Tools

WHO CNS Tumor Grade (2021)GPA (Graded Prognostic Assessment)Diagnosis-Specific GPA (Brain Mets)

Frequently Asked Questions

When should RPA (Brain Metastases) be used?

Use it for patients with primary or metastatic central nervous system disease in the setting described by the model when all required inputs and the intended clinical setting are confirmed.

Can RPA (Brain Metastases) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.