CLINICAL ONCOLOGY AND RESEARCH | ISSN 2613-4942 Available online at www.sciencerepository.org Science Repository * Correspondence to: Erkan Topkan, M.D., Baskent University Medical Faculty, Department of Radiation Oncology, 01120, Adana, Turkey; Tel: 905337381069; Fax: 903223444452; ORCID ID: 0000-0001-8120-7123; E-mail: docdretopkan@gmail.com © 2020 Erkan Topkan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved. http://dx.doi.org/10.31487/j.COR.2020.03.03 Research Article Common Prognostic Scoring Systems for Patients Presenting with Brain Metastases Erkan Topkan 1* , Ahmet Kucuk 2 , Duygu Sezen 3 , Sukran Senyurek 3 , Eyub Yasar Aydemir 3 , Nulifer Kılıc Durankus 3 , Esma Didem Ikiz 4 , Yasemin Bolukbasi 3 , Berrin Pehlivan 5 and Ugur Selek 3 1 Baskent University Medical Faculty, Department of Radiation Oncology, Adana, Turkey 2 Mersin City Education and Research Hospital, Radiation Oncology Clinics, Mersin, Turkey 3 Koc University, School of Medicine, Department of Radiation Oncology, Istanbul, Turkey 4 Ege University, School of Medicine, Radiation Oncology Department, Izmir, Turkey 5 Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey A R T I C L E I N F O Article history: Received: 20 February, 2020 Accepted: 9 March, 2020 Published: 17 March, 2020 Keywords: Brain metastasis scoring systems prognosis survival A B S T R A C T Brain metastases (BM) of various primaries merely remain the most prevalent type of intracranial tumors, and approximately 25% of all cancer patients are diagnosed with this poor prognostic disease condition somewhere during their treatment course. Contingent upon the general wellbeing status of the potential patient, currently available major treatment options typically include palliative radiotherapy, chemotherapy, and best supportive care. Various published studies have convincingly shown the likelihood to stratify BM patients into particular prognostic gatherings according to the conceivable combinations of multiple patients- and tumor-related characteristics; namely the prognostic scoring systems, which might be useful in the accurate prediction of survival, and thusly, the appropriate choice of the best-fit treatment alternative. In this present article, we meant to review the pros and cons of the as of now accessible and broadly acknowledged prognostic scoring systems for BMs and their clinical values. © 2020 Erkan Topkan. Hosting by Science Repository. All rights reserved. Introduction Approximately 25% of all cancer patients are diagnosed with brain metastases (BM), which tragically increases up to 64% throughout their treatment course [1-4]. The exact incidence of the newly diagnosed BM is unknown, but it is estimated to be 3 to 10 times the incidence of newly diagnosed primary brain tumors [5, 6]. The BM incidence assuredly appears to further rise in the foreseeable future as a tangible result of longer survival expectations following the successful implementation of more sophisticated diagnostic imaging modalities and earlier commencement of effective local/regional and systemic anticancer interventions. Hypothetically, all aggressive cancers may metastasize to the brain, however, the majority of BMs stem from the lung cancers (36-64%), breast cancers (15-25%), malignant melanoma (15-25%), and gastrointestinal cancers (5-10%), with an unknown primary in further 10-15%, respectively [7-9]. Malignant melanomas have the highest penchant for BM amongst all primary malignant tumors [10]. The distribution patterns of BMs usually follow the natural brain bloodstream pathways: 80%, 15%, and 5% in the cerebral hemispheres, cerebellum, and brainstem, individually [11]. Moreover, most BMs typically emerge at the intersection zones between the gray and white matters of the brain, presumably as the desired result of the natural localization of the capillary beds at these regions [12]. Currently, essentially 50% of all BMs are multiple at diagnosis possibly owing to the frequent utilization of highly sensitive and specific magnetic resonance imaging (MRI). Presentation with BM indicates an adverse prognostic condition with expected survival duration of usually less than a year, yet the prognosis of BM patients may differ broadly due to multiple factors; including the age, performance status, total number and volume of the metastatic lesion(s), treatment modality utilized against the BM, extracranial disease status, and histology of the primary malignancy. Various tumor-