预测接受放射治疗的骨转移患者的生存情况：加藤计分系统的验证研究。
Predicting the survival of patients with bone metastases treated with radiation therapy: a validation study of the Katagiri scoring system.
机构信息
Department of Radiation Oncology, Hyogo Cancer Center, 13-70, Kita-oji, Akashi, Hyogo, Japan.
Department of Radiation Oncology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan.
出版信息
Radiat Oncol. 2019 Jan 18;14(1):13. doi: 10.1186/s13014-019-1218-z.
BACKGROUND
The selection of radiation therapy dose fractionation schedules for bone metastases is often based on the estimation of life expectancy. Therefore, accurate prognosis prediction is an important issue. It is reported that the Katagiri scoring system can be used to predict the survival of patients with bone metastases. We aimed to assess prognostic factors and validate the Katagiri scoring system in patients who were treated with radiation therapy for bone metastases.
MATERIALS/METHODS: We retrospectively reviewed data of all patients who were treated with radiation therapy for bone metastases between 2004 and 2013. Age, sex, Karnofsky performance status (KPS), Eastern Cooperative Oncology Group performance status (ECOG PS), primary site (lesions and characteristics), visceral metastases, laboratory data, previous chemotherapy, and multiple bone metastases were analyzed for associations with overall survival (OS). Katagiri scores were calculated for each patient and were used to compare OS.
RESULTS
Out of the 616 patients included in this analysis, 574 had died and 42 remained alive. The median follow-up time for survivors was 42 months. Univariate analysis revealed that age (P = 0.604) and multiple bone metastases (P = 0.691) were not significantly associated with OS. Multivariate analysis revealed that sex, ECOG PS, KPS, primary characteristics, visceral metastases, laboratory data, and previous chemotherapy were significantly associated with OS. The survival rates at 3, 6, 12, and 24 months, categorized by Katagiri score, were as follows: score 0-3, 94.4, 77.8, and 61.1%, respectively; score 4-6, 67.7, 48.7, and 31.2%, respectively; and score 7-10, 39.1, 22.1, and 9.0%, respectively (P < 0.001).
CONCLUSION
Sex, ECOG PS, KPS, primary characteristics, visceral metastases, laboratory data, and previous chemotherapy were significant predictors of survival in patients with bone metastases. The Katagiri scoring system was significantly correlated with OS and can help us select the optimal dose-fractionation.
背景
骨转移患者的放射治疗剂量分割方案的选择通常基于对预期寿命的估计。因此，准确的预后预测是一个重要问题。据报道，Katagiri 评分系统可用于预测骨转移患者的生存情况。我们旨在评估预后因素并验证 Katagiri 评分系统在接受放射治疗的骨转移患者中的应用。
材料/方法：我们回顾性分析了 2004 年至 2013 年间接受放射治疗的骨转移患者的数据。分析了年龄、性别、卡氏功能状态（KPS）、东部合作肿瘤组体能状态（ECOG PS）、原发部位（病变和特征）、内脏转移、实验室数据、既往化疗和多处骨转移与总生存期（OS）的关系。为每位患者计算了 Katagiri 评分，并用于比较 OS。
结果
在本分析中纳入的 616 例患者中，574 例死亡，42 例存活。幸存者的中位随访时间为 42 个月。单因素分析显示，年龄（P=0.604）和多处骨转移（P=0.691）与 OS 无显著相关性。多因素分析显示，性别、ECOG PS、KPS、原发特征、内脏转移、实验室数据和既往化疗与 OS 显著相关。Katagiri 评分 0-3 分、4-6 分和 7-10 分的 3、6、12 和 24 个月生存率分别为：94.4%、77.8%、61.1%、67.7%、48.7%、31.2%、39.1%、22.1%和 9.0%（P<0.001）。
结论
性别、ECOG PS、KPS、原发特征、内脏转移、实验室数据和既往化疗是骨转移患者生存的显著预测因素。Katagiri 评分系统与 OS 显著相关，可帮助我们选择最佳剂量分割。
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