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多中心 DKTK/ROG 分析:验证新的胶质瘤患者再放疗风险评分(RRRS)预测复发后生存的能力。

Independent validation of a new reirradiation risk score (RRRS) for glioma patients predicting post-recurrence survival: A multicenter DKTK/ROG analysis.

机构信息

Department of Radiation Oncology, University Hospital, LMU Munich, Germany; German Cancer Consortium (DKTK), partner sites Munich, Heidelberg, Berlin, Frankfurt, Tübingen, Freiburg, Dresden, Essen; and German Cancer Research Center (DKFZ), Heidelberg, Germany.

German Cancer Consortium (DKTK), partner sites Munich, Heidelberg, Berlin, Frankfurt, Tübingen, Freiburg, Dresden, Essen; and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology, University of Heidelberg, Germany; Heidelberg Institute for Radiation Oncology (HIRO), Germany.

出版信息

Radiother Oncol. 2018 Apr;127(1):121-127. doi: 10.1016/j.radonc.2018.01.011. Epub 2018 Feb 9.

Abstract

BACKGROUND AND PURPOSE

Reirradiation (reRT) is a valid option with considerable efficacy in patients with recurrent high-grade glioma, but it is still not known which patients might be optimal candidates for a second course of irradiation. This study validated a newly developed prognostic score independently in an external patient cohort.

MATERIAL AND METHODS

The reRT risk score (RRRS) is based on a linear combination of initial histology, clinical performance status, and age derived from a multivariable model of 353 patients. This score can predict post-recurrence survival (PRS) after reRT. The validation dataset consisted of 212 patients.

RESULTS

The RRRS differentiates three prognostic groups. Discrimination and calibration were maintained in the validation group. Median PRS times in the development cohort for the good/intermediate/poor risk categories were 14.2, 9.1, and 5.3 months, respectively. The respective groups within the validation cohort displayed median PRS times of 13.8, 8.8, and 3.8 months, respectively. Uno's C for development data was 0.64 (CI: 0.60-0.69) and for validation data 0.63 (CI: 0.58-0.68).

CONCLUSIONS

The RRRS has been successfully validated in an independent patient cohort. This linear combination of three easily determined clinicopathological factors allows for a reliable classification of patients and may be used as stratification factor for future trials.

摘要

背景与目的

再放疗(reRT)是复发性高级别胶质瘤患者极具疗效的选择,但目前仍不清楚哪些患者是接受二次放疗的最佳候选者。本研究在外部患者队列中独立验证了一种新开发的预后评分。

材料与方法

再放疗风险评分(RRRS)基于从 353 名患者的多变量模型中得出的初始组织学、临床表现状态和年龄的线性组合。该评分可预测再放疗后的复发后生存(PRS)。验证数据集包含 212 名患者。

结果

RRRS 可区分三个预后组。在验证组中保持了区分度和校准度。在开发队列中,良好/中等/差风险类别的中位 PRS 时间分别为 14.2、9.1 和 5.3 个月。验证队列中相应的组分别显示为 13.8、8.8 和 3.8 个月。开发数据的 Uno C 为 0.64(CI:0.60-0.69),验证数据为 0.63(CI:0.58-0.68)。

结论

RRRS 在独立的患者队列中得到了成功验证。这三个易于确定的临床病理因素的线性组合允许对患者进行可靠分类,并且可以作为未来试验的分层因素。

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