Hartsell William F, Desilvio Michelle, Bruner Deborah Watkins, Scarantino Charles, Ivker Robert, Roach Mack, Suh John, Demas William F, Movsas Benjamin, Petersen Ivy A, Konski Andre A
Department of Radiation Oncology, Advocate Good Samaritan Cancer Center, Downers Grove, Illinois 60515, USA.
J Palliat Med. 2008 Jun;11(5):723-8. doi: 10.1089/jpm.2007.0259.
To determine if physician prediction of survival duration (PSD) is accurate for patients with metastatic breast or prostate cancer.
Radiation Therapy Oncology Group 9714 (RTOG 9714) was a randomized comparison of radiotherapy schedules for treatment of bone metastases. The treating physician assigned a baseline Karnofsky Performance Score (KPS) and predicted survival duration at study entry. Patients completed the Functional Assessment of Cancer Therapy (FACT). These three were compared to actual survival time.
Eight hundred ninety-eight patients were eligible and analyzable. Actual median survival was 9.3 months. The median PSD was 12 months. PSD, KPS, and FACT were all moderately correlated with actual survival. Patients with higher KPS had a longer survival time (882 patients, Spearman's rho = 0.259, p < 0.0001). The median survival of the 618 expired patients is 6.5 months (PSD was 12 months). The PSD was within 1 month of actual survival in 61 (10%), with 177 (29%) patients surviving more than 1 month longer than predicted and 375 (61%) surviving more than 1 month less than predicted. A univariate analysis of actual overall survival was performed, dividing the PSD into 4 groups. For predicted survivals of 6 months or less, less than 6 to less than 12 months, 12 months, and more than 12 months, median actual survivals were 7.0, 7.2, 9.7. and 13.5 months (p < 0.0001).
KPS, FACT scores, and PSD all are correlated with actual survival. Physicians on this study were able to predict which patients would have longer survival times, although prediction of survival was optimistic compared to actual survival by an average of 3 months.
确定医生对转移性乳腺癌或前列腺癌患者生存时间的预测（PSD）是否准确。
放射治疗肿瘤学组9714（RTOG 9714）是一项关于骨转移瘤治疗放疗方案的随机对照研究。治疗医生在研究开始时指定基线卡诺夫斯基性能评分（KPS）并预测生存时间。患者完成癌症治疗功能评估（FACT）。将这三项与实际生存时间进行比较。
898例患者符合条件且可进行分析。实际中位生存期为9.3个月。中位PSD为12个月。PSD、KPS和FACT均与实际生存有中度相关性。KPS较高的患者生存时间更长（882例患者，Spearman秩相关系数=0.259，p<0.0001）。618例死亡患者的中位生存期为6.5个月（PSD为12个月）。PSD与实际生存时间相差在1个月内的患者有61例（10%），177例（29%）患者的生存时间比预测的长1个月以上，375例（61%）患者的生存时间比预测的短1个月以上。对实际总生存期进行单因素分析，将PSD分为4组。对于预测生存期为6个月或更短、6个月以上至12个月以下、12个月以及12个月以上的患者，实际中位生存期分别为7.0、7.2、9.7和13.5个月（p<0.0001）。
KPS、FACT评分和PSD均与实际生存相关。本研究中的医生能够预测哪些患者的生存时间更长，尽管与实际生存相比，生存预测平均乐观3个月。
