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

Oorschot, Birgitt van; Käsmann, Lukas; Schild, Steven E.; Rades, Dirk

doi:10.21873/anticanres.11596

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…We decided to dichotomize our study population by score 0-2 vs. >2 because this resulted in reasonably balanced group size and thereby improved statistical power, compared to, e.g., a cutoff of 4 or 5. Palliative radiotherapy is a well-established, widely used means of providing symptom improvement, e.g., of dyspnea, pain and cough, and, in selected patients with less advanced disease, increased overall survival (10)(11)(12)(13)(14). This treatment is often associated with improved quality of life and functional independence and should be combined with other, e.g., drug-based supportive measures (15).…”

Section: Discussionmentioning

confidence: 99%

Does Patient-reported Dyspnea Reflect Thoracic Disease Characteristics in Patients with Incurable Cancer?

Nieder

Kämpe

Engljähringer

2018

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Section: Discussionmentioning

confidence: 99%

Does Patient-reported Dyspnea Reflect Thoracic Disease Characteristics in Patients with Incurable Cancer?

Nieder

Kämpe

Engljähringer

2018

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“…Determining treatment strategies in palliative radiotherapy hinges on an accurate assessment of survival prognosis. Several prognostic models exist, many incorporating performance status (PS) as a factor [13,[20][21][22][23][24][25][26][27][28]. However, predicting survival at the time of choosing a regimen is often challenging, with oncologists tending to overestimate survival duration [29,30].…”

Section: Introductionmentioning

confidence: 99%

Deterioration of Performance Status during Palliative Radiotherapy Suggests a Significant Short Survival Duration: Indicating the Necessities for Considering Radiotherapy Discontinuation

Maemoto,

Kushi,

Owan

et al. 2024

Current Oncology

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Discontinuation of palliative radiotherapy due to a patient’s declining general condition poses a clinical dilemma for palliative care physicians. This study aimed to investigate the survival duration of patients whose performance status (PS) deteriorated during palliative radiotherapy and inform decisions regarding early treatment discontinuation. We retrospectively analyzed data from patients referred from our institute’s palliative care department who underwent ≥10 fractions of palliative radiotherapy between March 2017 and December 2021. PS was assessed using the Eastern Cooperative Oncology Group (ECOG) scale. Survival duration was calculated from the final day of palliative radiotherapy to death using the Kaplan–Meier method. A total of 35 patients underwent palliative radiotherapy. Seven (20%) experienced deterioration in ECOG PS during treatment. Their median survival duration was significantly shorter at 22 days (95% confidence interval: 1–94 days) compared to 125 days (95% confidence interval: 82–150 days) for the 28 patients whose PS remained stable (p = 0.0007). Deterioration in ECOG PS during palliative radiotherapy signifies a markedly shorter survival duration. Careful assessment of a patient’s condition throughout treatment is crucial, and early discontinuation should be considered if their general health worsens rather than strictly adhering to the initial schedule.

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“…Since their development 50 years ago, the KPS and ECOG PS have been established as standard simple assessment tools to determine the patient functional status (15,16). KPS and ECOG PS have been shown to be correlated with response and tolerability to oncological treatment modalities, (overall) survival, and quality of life (8,10,17,18). Assessing the patient's general condition with KPS or ECOG PS also has several limitations which need to be considered e.g.…”

Section: Discussionmentioning

confidence: 99%

Performance Status and Its Changes Predict Outcome for Patients With Inoperable Stage III NSCLC Undergoing Multimodal Treatment

et al. 2019

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Background/Aim: Patient performance scores are used widely in clinical practice to assess a patient's general condition. The aim of this study was to evaluate the prognostic role of Eastern Cooperative Oncology Group performance score (ECOG PS) before, after and its changes during chemoradiotherapy in patients with stage III nonsmall cell lung cancer (NSCLC). Patients and Methods: Records of 99 patients with stage III NSCLC were evaluated. ECOG PS before, during and after chemoradiotherapy was analyzed for prognostic impact on overall (OS) and eventfree (EFS) survival. Results: Median OS considering the entire cohort was 20.8 months (range=15.3-26.2 months). Median OS, and 1-and 2-year survival rates were 26.4 months, 85% and 53% in patients with ECOG PS 0 versus 18.9 months, 69% and 37% in patients with ECOG PS 1 (p=0.1,, respectively. After the first follow-up, 35% of patients presented worsening ECOG PS, while in 65% it was stable or improved. Median EFS according to ECOG PS 0, 1, 2 and 3 was 9.6, 9.0, 7.9 and 3.5 months, respectively, at the first follow-up (p=0.018, log-rank test). Deterioration of ECOG PS after chemoradiotherapy resulted in reduced OS in the subgroups with initial ECOG PS 0 and 1 (p=0.005 and p=0.001, log-rank test). Conclusion: ECOG PS and its changes have a strong impact on patient outcome. Deterioration of performance status was a strong negative prognostic factor for EFS and OS.Lung cancer remains the leading cause of cancer-related mortality worldwide (1-4). Over 80% of all lung cancers are characterized as non-small cell lung cancer (NSCLC), mainly squamous cell carcinoma, adenocarcinoma and largecell carcinoma (3-5). Stage III NSCLC represents a locally advanced stage with heterogenous characteristics such as extensive lymph node (N3) involvement, large tumour volumes or infiltration of surrounding structures e.g. mediastinum, heart or spinal column (3,4,6).Karnofsky's performance status (KPS) or the Eastern Cooperative Oncology Group Performance Status Scale (ECOG PS) are widely used methods of assessing the functional status of cancer patients (7-11). Success of the individualized multimodal treatment highly depends on general and functional patient performance. A multimodal approach including chemo-, immunotherapy and locoregional thoracic irradiation is considered a standard of care in the treatment of inoperable stage III NSCLC. Patients with a good performance status (ECOG PS 0 or 1) should receive definitive concurrent chemoradiotherapy (CRT) followed by consolidation programmed cell death 1 ligand 1 (PD-L1) inhibition (3,4,12,13). However, not all patients will be able to tolerate intensified multimodal approaches and understanding the role of patient performance during the course of treatment is necessary for personalized decision making. The aim of this retrospective study was to evaluate the prognostic role of ECOG PS before, during and after CRT in stage III NSCLC.

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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

Abstract: The score was reproducible and valid for estimating the 6-month survival of lung cancer patients assigned to palliative thoracic radiotherapy.

Cited by 3 publications

References 10 publications

Does Patient-reported Dyspnea Reflect Thoracic Disease Characteristics in Patients with Incurable Cancer?

Does Patient-reported Dyspnea Reflect Thoracic Disease Characteristics in Patients with Incurable Cancer?

Deterioration of Performance Status during Palliative Radiotherapy Suggests a Significant Short Survival Duration: Indicating the Necessities for Considering Radiotherapy Discontinuation

Performance Status and Its Changes Predict Outcome for Patients With Inoperable Stage III NSCLC Undergoing Multimodal Treatment

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