Jensen Garrett, Tang Chad, Hess Kenneth R, Bishop Andrew J, Pan Hubert Y, Li Jing, Yang James N, Tannir Nizar M, Amini Behrang, Tatsui Claudio, Rhines Laurence, Brown Paul D, Ghia Amol J
Baylor College of Medicine, Houston, Texas, USA.
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Radiosurg SBRT. 2017;5(1):25-34.
We sought to validate the Prognostic Index for Spinal Metastases (PRISM), a scoring system that stratifies patients into subgroups by overall survival.Methods and materials: The PRISM was previously created from multivariate Cox regression with patients enrolled in prospective single institution trials of stereotactic spine radiosurgery (SSRS) for spinal metastasis. We assess model calibration and discrimination within a validation cohort of patients treated off-trial with SSRS for metastatic disease at the same institution.
The training and validation cohorts consisted of 205 and 249 patients respectively. Similar survival trends were shown in the 4 PRISM. Survival was significantly different between PRISM subgroups (P<0.0001). C-index for the validation cohort was 0.68 after stratification into subgroups.
We internally validated the PRISM with patients treated off-protocol, demonstrating that it can distinguish subgroups by survival, which will be useful for individualizing treatment of spinal metastases and stratifying patients for clinical trials.
我们试图验证脊柱转移预后指数（PRISM），这是一种根据总生存期将患者分层为不同亚组的评分系统。
PRISM先前是通过多变量Cox回归创建的，纳入的患者来自一项针对脊柱转移的立体定向脊柱放射外科（SSRS）前瞻性单机构试验。我们在同一机构对接受非试验性SSRS治疗转移性疾病的患者验证队列中评估模型校准和区分度。
训练队列和验证队列分别由205例和249例患者组成。4个PRISM亚组显示出相似的生存趋势。PRISM亚组之间的生存率有显著差异（P<0.0001）。分层为亚组后，验证队列的C指数为0.68。
我们对接受非方案治疗的患者进行了PRISM内部验证，表明它可以根据生存期区分亚组，这将有助于脊柱转移瘤的个体化治疗以及为临床试验对患者进行分层。
