Chow Edward, James Jennifer L, Hartsell William, Scarantino Charles W, Ivker Robert, Roach Mack, Suh John H, Demas William, Konski Andre, Bruner Deborah Watkins
Odette Cancer Center, Toronto, ON, Canada.
RTOG Statistical Center, Philadelphia, PA, USA.
World J Oncol. 2011 Aug;2(4):181-190. doi: 10.4021/wjon325w. Epub 2011 Aug 24.
The objective of this study was to validate a simple predictive model for survival of patients with advanced cancer.
Previous studies with training and validation datasets developed a model predicting survival of patients referred for palliative radiotherapy using three readily available factors: primary cancer site, site of metastases and Karnofsky performance score (KPS). This predictive model was used in the current study, where each factor was assigned a value proportional to its prognostic weight and the sum of the weighted scores for each patient was survival prediction score (SPS). Patients were also classified according to their number of risk factors (NRF). Three risk groups were established. The Radiation Therapy and Oncology Group (RTOG) 9714 data was used to provide an additional external validation set comprised of patients treated among multiple institutions with appropriate statistical tests.
The RTOG external validation set comprised of 908 patients treated at 66 different radiation facilities from 1998 to 2002. The SPS method classified all patients into the low-risk group. Based on the NRF, two distinct risk groups with significantly different survival estimates were identified. The ability to predict survival was similar to that of the training and previous validation datasets for both the SPS and NRF methods.
The three variable NRF model is preferred because of its relative simplicity.
本研究的目的是验证一种用于晚期癌症患者生存情况的简单预测模型。
先前的研究利用训练数据集和验证数据集，通过三个易于获取的因素建立了一个预测接受姑息性放疗患者生存情况的模型，这三个因素分别是原发癌部位、转移部位和卡诺夫斯基体能状态评分（KPS）。本研究使用了该预测模型，其中每个因素被赋予与其预后权重成比例的值，每个患者的加权分数总和即为生存预测分数（SPS）。患者还根据其危险因素数量（NRF）进行分类。建立了三个风险组。放射治疗肿瘤学组（RTOG）9714的数据被用于提供一个额外的外部验证集，该验证集由在多个机构接受治疗的患者组成，并进行了适当的统计检验。
RTOG外部验证集包括1998年至2002年在66个不同放疗机构接受治疗的908名患者。SPS方法将所有患者分类为低风险组。基于NRF，确定了两个生存估计有显著差异的不同风险组。对于SPS和NRF方法，预测生存的能力与训练数据集和先前验证数据集的能力相似。
由于其相对简单性，三个变量的NRF模型更受青睐。
