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Table 1 Krauze Scoring System

From: Re-irradiation for recurrent glioma- the NCI experience in tumor control, OAR toxicity and proposal of a novel prognostic scoring system

Prognostics Factor

Subgroups

Value for prognostic score

Independent Factors

Patient Age

>60 years

1

 

50–60 years

2

 

<50 years

3

KPS

<50%

1

 

50–70%

2

 

>70%

3

Histology

WHO Grade IV

1

 

WHO Grade III

2

 

WHO Grade II

3

Presence of symptoms

Documented neurological symptoms related to recurrence requiring steroid management

1

 

Documented neurologicalsymptoms relatedto recurrence or impending neuro symptoms

2

 

No neurological symptoms related to recurrence

3

Target Control

Tumor size (GTV)

>500 cm3 or diffuse disease/ gliomatosis

1

 

20–500 cm3

2

 

<20 cm3

3

Tumor recurrencelocation withrespect to originaltreatment field (60Gy isodose line)

<1 cm away or completelywithin the original treatment field

1

 

1–3 cm away

2

 

>3 cm away

3

Diffuse disease present

Multiple T1 gadolinium- enhancing lesions

1

 

T2 FLAIR diffuse involvement

2

 

None (localized recurrence only)

3

Anticipated Toxicity Risk

OAR location with respect to recurrence area

>1 cm away from or in the recurrence area

1

 

1–3 cm away from recurrence area

2

 

>3 cm away from the recurrence area

3

OAR dose contribution from original treatmenta

<90% dose allowed as per Quantec dose constraints

1

 

Within +/− 10% of dose allowed as per Quantec constraints

2

 

Exceeds >10% over the Quantec constraints

3

Disease free interval from initial treatment with radiation

<1 year

1

 

1–3 years

2

 

>3 years

3

  1. aOAR QUANTEC dose constraints: Chiasm: 55Gy, Optic Nerves: 55Gy, Brain Stem: 54 Gy. WHO World Health Organisation