External Validation of a Prognostic Score for Patients Receiving Palliative Thoracic Radiotherapy for Lung Cancer

Nieder, Carsten; Tollåli, Terje; Haukland, Ellinor; Reigstad, Anne; Flatøy, Liv Randi; Dalhaug, Astrid

doi:10.1016/j.cllc.2017.01.006

Cited by 10 publications

(12 citation statements)

References 17 publications

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“…In the Norwegian study, the 1-year survival rates of the three prognostic groups were 2%, 21% and 32%, respectively. When compared to our previous study, the results were similar in the 10-11 points group (2% versus 8%) and the 12-14 points group (21% versus 19%) but not in the 15-17 points group (32% versus 69%) (7,8). However, one has to keep in mind that our scoring system was designed specifically to estimate the 6-month survival probability, not the 1-year survival probability or the median survival time (7).…”

Section: Discussionsupporting

confidence: 53%

“…The survival times of patients assigned to palliative thoracic radiotherapy of locally advanced lung cancer may vary considerably, ranging between a few weeks and a year or longer (7,8). Personalization of palliative irradiation for lung cancer includes individualizing treatment to the patient's remaining lifespan (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…However, this scoring system had not yet been properly validated. Recently, a group from Norway aimed to perform an external validation of our scoring system in a retrospective series of 232 lung cancer patients (8). The authors reported median survival times for the three prognostic groups of 1.2 months (10-11 points), 5.3 months (12-14 points) and 8.2 months (15-17 points).…”

Section: Discussionmentioning

confidence: 99%

“…A similar cut-off is widely used for scoring systems developed to predict the survival of lung cancer patients receiving palliative radiotherapy of brain metastases or malignant epidural spinal cord compression (15,16). Therefore, the attempt to validate our scoring system in the study from Norway did not investigate the specific end-point the scoring system was designed to predict (7,8). However, they have validated that the score predicts survival.…”

Section: Discussionmentioning

confidence: 99%

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Validation of a Score Developed to Estimate the 6-month Survival of Patients Treated with Palliative Local Radiotherapy for Advanced Lung Cancer

Oorschot

Käsmann

Schild

et al. 2017

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Validation of a Score Developed to Estimate the 6-month Survival of Patients Treated with Palliative Local Radiotherapy for Advanced Lung Cancer

Oorschot

Käsmann

Schild

et al. 2017

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“…Karnofsky score > 70 was borderline significant for survival. This was validated in a larger retrospective study [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 88%

Fractionated palliative thoracic radiotherapy in non-small cell lung cancer – futile or worth-while?

et al. 2018

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BackgroundPalliative thoracic radiotherapy (PTR) can relieve symptoms originating from intra-thoracic disease. The optimal timing and fractionation of PTR is unknown. Time to effect is 2 months. The primary aim of this retrospective study was to investigate survival after PTR, hypothesizing that a significant number of patients received futile fractionated PTR. The secondary aim was to find prognostic factors to guide treatment decisions.MethodsPatients with non-small-cell lung cancer (NSCLC) planned for PTR in the period of 2010-2011 at the University Hospital of Copenhagen were included. We noted pathology, tumor, node and metastasis (TNM) classification of malignant tumors, stage, indication, start date, schedule for PTR, completed y/n, performance status (PS) and time of death. Analyses were performed as an intention-to-treat using Cox regression, Fishers exact test and Kaplan Meier.ResultsA total of 159 patients were included. Median overall survival (OS) was 4.2 months. Sixteen patients (10%) did either not begin or finish PTR. Of these, eight (5%) died prior to or during PTR. Of the 151 patients receiving PTR, sixteen patients (11%) died within 14 days, thirty-three (22%) within 30 days and fifty (33%) within 2 months. PS 0-1 and squamous cell carcinoma were correlated with a better survival.ConclusionsOur study show that a significant number of patients who received PTR died before they could achieve optimal effect of the treatment. PS and histology were significant prognostic factors favoring PS 0-1 and squamous cell carcinoma. Based on our study, we suggest that patients with PS 0-1 should be considered for fractionated PTR whereas patients with PS ≥ 2 should be considered for high dose single fraction only or supportive palliative care.Electronic supplementary materialThe online version of this article (10.1186/s12904-017-0270-4) contains supplementary material, which is available to authorized users.

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Palliative appropriateness criteria: external validation of a new method to evaluate the suitability of palliative radiotherapy fractionation

et al. 2023

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Background Recently, the palliative appropriateness criteria (PAC) score, a novel metric to aid clinical decision-making between different palliative radiotherapy fractionation regimens, has been developed. It includes baseline parameters including but not limited to performance status. The researchers behind the PAC score analyzed the percent of remaining life (PRL) on treatment. The latter was accomplished by calculating the time between start and finish of palliative radiotherapy (minimum 1 day in case of a single-fraction regimen) and dividing it by overall survival in days from start of radiotherapy. The purpose of the present study was to validate this novel metric. Patients and methods The retrospective validation study included 219 patients (287 courses of palliative radiotherapy). The methods were identical to those employed in the score development study. The score was calculated by assigning 1 point each to several factors identified in the original study and using the online calculator provided by the PAC developers. Results Median survival was 6 months and death within 30 days from start of radiotherapy was recorded in 13% of courses. PRL on treatment ranged from 1 to 23%, median 8%. Significant associations were confirmed between online-calculated PAC score, observed survival, and risk of death within 30 days from the start of radiotherapy. Patients with score 0 had distinctly better survival than all other groups. The score-predicted median risk of death within 30 days from start of radiotherapy was 22% in our cohort. A statistically significant correlation was found between predicted and observed risk (p < 0.001). The original and present study were not perfectly concordant regarding number and type of baseline parameters that should be included when calculating the PAC score. Conclusion This study supports the dual strategy of PRL and risk of early death calculation, with results stratified for fractionation regimen, in line with the original PAC score study. When considering multifraction regimens, the PAC score identifies patients who may benefit from shorter courses. Additional work is needed to answer open questions surrounding the underlying components of the score, because the original and validation study were only partially aligned.

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External Validation of a Prognostic Score for Patients Receiving Palliative Thoracic Radiotherapy for Lung Cancer

Cited by 10 publications

References 17 publications

Validation of a Score Developed to Estimate the 6-month Survival of Patients Treated with Palliative Local Radiotherapy for Advanced Lung Cancer

Validation of a Score Developed to Estimate the 6-month Survival of Patients Treated with Palliative Local Radiotherapy for Advanced Lung Cancer

Fractionated palliative thoracic radiotherapy in non-small cell lung cancer – futile or worth-while?

Palliative appropriateness criteria: external validation of a new method to evaluate the suitability of palliative radiotherapy fractionation

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