Predictive model for survival in patients having repeat radiation treatment for painful bone metastases

Edward Chow; Keyue Ding; Wendy R Parulekar; Rebecca K S Wong; Yvette M van der Linden; Daniel Roos; William F Hartsell; Peter Hoskin; Jackson S Y Wu; Abdenour Nabid; Jan Willem Leer; Ernest Vonk; Scott Babington; William F Demas; Carolyn F Wilson; Michael Brundage; Liting Zhu; Ralph M Meyer

doi:10.1016/j.radonc.2015.10.018

Predictive model for survival in patients having repeat radiation treatment for painful bone metastases

Edward Chow, Keyue Ding, Wendy R Parulekar, Rebecca K S Wong, Yvette M van der Linden, Daniel Roos, William F Hartsell, Peter Hoskin, Jackson S Y Wu, Abdenour Nabid, Jan Willem Leer, Ernest Vonk, Scott Babington, William F Demas, Carolyn F Wilson, Michael Brundage, Liting Zhu, Ralph M Meyer

Division of Cancer Sciences (L5)

Research output: Contribution to journal › Article › peer-review

Abstract

PURPOSE: To establish a survival prediction model in the setting of a randomized trial of re-irradiation for painful bone metastases.

METHODS: Data were randomly divided into training and testing sets with an approximately 3:2 ratio. Baseline factors of gender, primary cancer site, KPS, worst-pain score and age were included with backward variable selection to derive a model using the training set. A partial score was assigned by dividing the value of each statistically significant regression coefficient by the smallest statistically significant regression coefficient. The survival prediction score (SPS) was obtained by adding together partial scores for the variables that were statistically significant. Three risk groups were modelled.

RESULTS: The training set included 460 patients and the testing set 351 patients. Only KPS and primary cancer site reached the 5%-significance level. Summing up the partial scores assigned to KPS (90-100, 0; 70-80, 1; 50-60, 2) and primary cancer site (breast, 0; prostate, 1.3; other, 2.6; lung, 3) totalled the SPS. The 1/3 and 2/3 percentiles of the SPS were 2 and 3.6. For the testing set, the median survival of the 3 groups was not reached, 11.3 (95% C.I. 8.5 - not reached) and 5.2 months (95% C.I. 3.7-6.5). The 3, 6 and 12 month survival rates for the worst group were 64.4% (95% C.I. 55.3-72.1%), 43.0% (95% C.I. 34.0-51.8%) and 19.7% (95% C.I. 12.4-28.1%) respectively, similar to that in the training set.

CONCLUSION: This survival prediction model will assist in choosing dose fractionation. We recommend a single 8 Gy in the worst group identified.

Original language	English
Pages (from-to)	547-51
Number of pages	5
Journal	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume	118
Issue number	3
DOIs	https://doi.org/10.1016/j.radonc.2015.10.018
Publication status	Published - Mar 2016

Keywords

Aged
Bone Neoplasms/mortality
Dose Fractionation, Radiation
Female
Humans
Male
Middle Aged
Models, Statistical
Predictive Value of Tests
Proportional Hazards Models
Randomized Controlled Trials as Topic/methods
Survival Analysis
Survival Rate

Research Beacons, Institutes and Platforms

Manchester Cancer Research Centre

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.radonc.2015.10.018

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Chow, E., Ding, K., Parulekar, W. R., Wong, R. K. S., van der Linden, Y. M., Roos, D., Hartsell, W. F., Hoskin, P., Wu, J. S. Y., Nabid, A., Leer, J. W., Vonk, E., Babington, S., Demas, W. F., Wilson, C. F., Brundage, M., Zhu, L., & Meyer, R. M. (2016). Predictive model for survival in patients having repeat radiation treatment for painful bone metastases. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 118(3), 547-51. https://doi.org/10.1016/j.radonc.2015.10.018

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title = "Predictive model for survival in patients having repeat radiation treatment for painful bone metastases",

abstract = "PURPOSE: To establish a survival prediction model in the setting of a randomized trial of re-irradiation for painful bone metastases.METHODS: Data were randomly divided into training and testing sets with an approximately 3:2 ratio. Baseline factors of gender, primary cancer site, KPS, worst-pain score and age were included with backward variable selection to derive a model using the training set. A partial score was assigned by dividing the value of each statistically significant regression coefficient by the smallest statistically significant regression coefficient. The survival prediction score (SPS) was obtained by adding together partial scores for the variables that were statistically significant. Three risk groups were modelled.RESULTS: The training set included 460 patients and the testing set 351 patients. Only KPS and primary cancer site reached the 5%-significance level. Summing up the partial scores assigned to KPS (90-100, 0; 70-80, 1; 50-60, 2) and primary cancer site (breast, 0; prostate, 1.3; other, 2.6; lung, 3) totalled the SPS. The 1/3 and 2/3 percentiles of the SPS were 2 and 3.6. For the testing set, the median survival of the 3 groups was not reached, 11.3 (95% C.I. 8.5 - not reached) and 5.2 months (95% C.I. 3.7-6.5). The 3, 6 and 12 month survival rates for the worst group were 64.4% (95% C.I. 55.3-72.1%), 43.0% (95% C.I. 34.0-51.8%) and 19.7% (95% C.I. 12.4-28.1%) respectively, similar to that in the training set.CONCLUSION: This survival prediction model will assist in choosing dose fractionation. We recommend a single 8 Gy in the worst group identified.",

keywords = "Aged, Bone Neoplasms/mortality, Dose Fractionation, Radiation, Female, Humans, Male, Middle Aged, Models, Statistical, Predictive Value of Tests, Proportional Hazards Models, Randomized Controlled Trials as Topic/methods, Survival Analysis, Survival Rate",

author = "Edward Chow and Keyue Ding and Parulekar, {Wendy R} and Wong, {Rebecca K S} and {van der Linden}, {Yvette M} and Daniel Roos and Hartsell, {William F} and Peter Hoskin and Wu, {Jackson S Y} and Abdenour Nabid and Leer, {Jan Willem} and Ernest Vonk and Scott Babington and Demas, {William F} and Wilson, {Carolyn F} and Michael Brundage and Liting Zhu and Meyer, {Ralph M}",

year = "2016",

month = mar,

doi = "10.1016/j.radonc.2015.10.018",

language = "English",

volume = "118",

pages = "547--51",

journal = "Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology",

issn = "0167-8140",

publisher = "Elsevier BV",

number = "3",

}

Chow, E, Ding, K, Parulekar, WR, Wong, RKS, van der Linden, YM, Roos, D, Hartsell, WF, Hoskin, P, Wu, JSY, Nabid, A, Leer, JW, Vonk, E, Babington, S, Demas, WF, Wilson, CF, Brundage, M, Zhu, L & Meyer, RM 2016, 'Predictive model for survival in patients having repeat radiation treatment for painful bone metastases', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, vol. 118, no. 3, pp. 547-51. https://doi.org/10.1016/j.radonc.2015.10.018

TY - JOUR

T1 - Predictive model for survival in patients having repeat radiation treatment for painful bone metastases

AU - Chow, Edward

AU - Ding, Keyue

AU - Parulekar, Wendy R

AU - Wong, Rebecca K S

AU - van der Linden, Yvette M

AU - Roos, Daniel

AU - Hartsell, William F

AU - Hoskin, Peter

AU - Wu, Jackson S Y

AU - Nabid, Abdenour

AU - Leer, Jan Willem

AU - Vonk, Ernest

AU - Babington, Scott

AU - Demas, William F

AU - Wilson, Carolyn F

AU - Brundage, Michael

AU - Zhu, Liting

AU - Meyer, Ralph M

PY - 2016/3

Y1 - 2016/3

N2 - PURPOSE: To establish a survival prediction model in the setting of a randomized trial of re-irradiation for painful bone metastases.METHODS: Data were randomly divided into training and testing sets with an approximately 3:2 ratio. Baseline factors of gender, primary cancer site, KPS, worst-pain score and age were included with backward variable selection to derive a model using the training set. A partial score was assigned by dividing the value of each statistically significant regression coefficient by the smallest statistically significant regression coefficient. The survival prediction score (SPS) was obtained by adding together partial scores for the variables that were statistically significant. Three risk groups were modelled.RESULTS: The training set included 460 patients and the testing set 351 patients. Only KPS and primary cancer site reached the 5%-significance level. Summing up the partial scores assigned to KPS (90-100, 0; 70-80, 1; 50-60, 2) and primary cancer site (breast, 0; prostate, 1.3; other, 2.6; lung, 3) totalled the SPS. The 1/3 and 2/3 percentiles of the SPS were 2 and 3.6. For the testing set, the median survival of the 3 groups was not reached, 11.3 (95% C.I. 8.5 - not reached) and 5.2 months (95% C.I. 3.7-6.5). The 3, 6 and 12 month survival rates for the worst group were 64.4% (95% C.I. 55.3-72.1%), 43.0% (95% C.I. 34.0-51.8%) and 19.7% (95% C.I. 12.4-28.1%) respectively, similar to that in the training set.CONCLUSION: This survival prediction model will assist in choosing dose fractionation. We recommend a single 8 Gy in the worst group identified.

AB - PURPOSE: To establish a survival prediction model in the setting of a randomized trial of re-irradiation for painful bone metastases.METHODS: Data were randomly divided into training and testing sets with an approximately 3:2 ratio. Baseline factors of gender, primary cancer site, KPS, worst-pain score and age were included with backward variable selection to derive a model using the training set. A partial score was assigned by dividing the value of each statistically significant regression coefficient by the smallest statistically significant regression coefficient. The survival prediction score (SPS) was obtained by adding together partial scores for the variables that were statistically significant. Three risk groups were modelled.RESULTS: The training set included 460 patients and the testing set 351 patients. Only KPS and primary cancer site reached the 5%-significance level. Summing up the partial scores assigned to KPS (90-100, 0; 70-80, 1; 50-60, 2) and primary cancer site (breast, 0; prostate, 1.3; other, 2.6; lung, 3) totalled the SPS. The 1/3 and 2/3 percentiles of the SPS were 2 and 3.6. For the testing set, the median survival of the 3 groups was not reached, 11.3 (95% C.I. 8.5 - not reached) and 5.2 months (95% C.I. 3.7-6.5). The 3, 6 and 12 month survival rates for the worst group were 64.4% (95% C.I. 55.3-72.1%), 43.0% (95% C.I. 34.0-51.8%) and 19.7% (95% C.I. 12.4-28.1%) respectively, similar to that in the training set.CONCLUSION: This survival prediction model will assist in choosing dose fractionation. We recommend a single 8 Gy in the worst group identified.

KW - Aged

KW - Bone Neoplasms/mortality

KW - Dose Fractionation, Radiation

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Models, Statistical

KW - Predictive Value of Tests

KW - Proportional Hazards Models

KW - Randomized Controlled Trials as Topic/methods

KW - Survival Analysis

KW - Survival Rate

U2 - 10.1016/j.radonc.2015.10.018

DO - 10.1016/j.radonc.2015.10.018

M3 - Article

C2 - 26515411

SN - 0167-8140

VL - 118

SP - 547

EP - 551

JO - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

IS - 3

ER -

Predictive model for survival in patients having repeat radiation treatment for painful bone metastases

Abstract

Keywords

Research Beacons, Institutes and Platforms

UN SDGs

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