BackgroundPersonalized therapy for bone metastases should consider the patients’ remaining lifespan. Estimation of survival can be facilitated with scoring tools. A new tool was developed, specifically designed to estimate 12-month survival.MethodsIn 445 patients irradiated for bone metastases, radiotherapy regimen plus 13 factors (age, gender, Karnofsky performance score (KPS), primary tumor type, interval between cancer diagnosis and RT of bone metastases, visceral metastases, other (non-irradiated) bone metastases, sites of bone metastases, number of irradiated sites, pathological fracture, fractionation of RT, pre-RT surgery, pre-RT administration of bisphosphonates/denosumab, pre-RT systemic anticancer treatment) were retrospectively analyzed for survival. Factors achieving significance (p < 0.05) or borderline significance (p < 0.055) on multivariate analysis were used for the scoring system. Twelve-month survival rates were divided by 10 (factor scores); factor scores were summed for each patient (patient scores).ResultsOn multivariate analysis, survival was significantly associated with KPS (hazard ratio (HR) 1.91, p < 0.001) and primary tumor type (HR 1.12, p < 0.001); age achieved borderline significance (HR 1.14, p = 0.054). These factors were used for the scoring tool. Patient scores ranged from 8 to 17 points. Three groups were designated: 8–9 (A), 10–14 (B) and 15–17 (C) points. Twelve-month survival rates were 9, 38 and 72% (p < 0.001); median survival times were 3, 8 and 24 months.ConclusionsThis new tool developed for patients irradiated for bone metastases at any site without spinal cord compression allows one to predict the survival of these patients and can aid physicians when assigning the treatment to individual patients.

Background: The remaining lifespan of patients with metastatic lung cancer should be considered when designing a personalized treatment program. To facilitate the estimation survival in lung cancer patients with bone metastases, a specific scoring system was created.Methods: One-hundred-and-fifty-three patients receiving fractionated radiotherapy for bone metastases without spinal cord compression from lung cancer were included in this retrospective study. Age, gender, Eastern Cooperative Oncology Group (ECOG) performance score, histology, interval from lung cancer diagnosis until irradiation of bone metastases, visceral metastases, additional bone metastases, type and number of irradiated sites, pathological fracture, upfront surgery and previous systemic treatment were evaluated for potential associations with survival. Those factors that were significant (P<0.05) or showed a trend (P≤0.10) on multivariate analysis were used to create the scoring system.Results: On multivariate analysis, ECOG performance score was significant (risk ratio: 2.77, P<0.001), and age showed a trend (risk ratio: 1.34, P=0.10). The following scoring points were assigned: age ≤65 years =1 point, age ≥66 years =0 points, ECOG performance score of 0-1 =1 point, and ECOG performance score of ≥2 =0 points. Three prognostic groups were obtained: 0 points (n=38), 1 point (n=71) and 2 points (n=44). Six-month survival rates were 21%, 41% and 75%, 12-month survival rates 7%, 27% and 56% (P<0.001).Conclusions: This scoring system can help estimate the remaining lifespan of lung cancer patients to be irradiated for bone metastases and will contribute to the personalization of their treatment.

Background/Aim: Understanding prognostic factors of survival are important for treatment personalization in cancer patients. This study aimed to identify such factors for patients irradiated for bone metastases from prostate cancer. Patients and Methods: Data from 74 patients irradiated between 01/2009 and 04/2019were retrospectively evaluated. Ten characteristics were investigated for survival. Results: Median survival in the entire cohort was 12 months. Survival rates at 3, 6, 9 and 12 months were 84%, 73%, 56% and 47%, respectively. On univariate analyses, the Eastern Cooperative Oncology Group (ECOG) performance score of 0-1 was associated with improved survival (p<0.001), absence of visceral metastases (p=0.099) and only one irradiated metastatic site (p=0.099) showed a trend. On Cox regression analysis, only ECOG performance score (risk ratio=3.58, p<0.001) was significant. Conclusion: ECOG performance score is an independent prognostic factor of survival after irradiation of bone metastases from prostate cancer and may allow better personalization of care.

Background/Aim: Individualization of treatment may improve the outcome of patients with bone metastases from breast cancer. To support physicians when selecting individualized programs for these patients, a simple instrument for predicting survival was created. Patients and Methods: In 126 female patients with breast cancer irradiated for bone metastases, 11 characteristics were evaluated with respect to survival. Results: On Cox regression analysis, Eastern Cooperative Oncology Group performance score (0-1 vs. ≥2; p=0.032) and visceral metastases (absence vs. presence; p=0.017) were independently associated with survival and incorporated into the scoring instrument. Three prognostic groups (0, 1 or 2 points) were designated with 12month survival rates of 38%, 57% and 91%, and 24-month survival rates of 32%, 36% and 80%, respectively (p<0.001). Conclusion: This easy-to-use scoring instrument allows physicians to estimate the lifespan of patients irradiated for bone metastases from breast cancer and can facilitate individualization of their treatment.

Background/Aim: Estimating survival is important for treatment personalization in patients with metastatic cancer. In this study, we aimed to develop a survival score for patients irradiated for bone metastases from colorectal cancer. Patients and Methods: Eleven factors were retrospectively analyzed in 25 patients, including age, gender, Eastern Cooperative Oncology Group performance score, tumor site, time between diagnosis of colorectal cancer and irradiation, visceral or other bone metastases, type and number of irradiated sites, upfront surgery and previous systemic treatment. Results: On multivariate analysis, performance score (p=0.005) and previous systemic treatment (p=0.007) were significantly associated with survival and used for the score. One point (performance score 0-1 or no previous systemic treatment) or 0 points (performance score ≥2 or previous systemic treatment) were assigned resulting in 0, 1 or 2 points. Six-month survival rates of these groups were 0%, 64% and 100%, respectively. Conclusion: This new survival score can support physicians during personalization of treatment for patients with bone metastases from colorectal cancer.