Rades Dirk, Haus Rapha, Janssen Stefan, Schild Steven E
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, USA.
Transl Lung Cancer Res. 2020 Aug;9(4):1067-1073. doi: 10.21037/tlcr-19-642.
The remaining lifespan of patients with metastatic lung cancer should be considered when designing a personalized treatment program. To facilitate the estimation survival in lung cancer patients with bone metastases, a specific scoring system was created.
One-hundred-and-fifty-three patients receiving fractionated radiotherapy for bone metastases without spinal cord compression from lung cancer were included in this retrospective study. Age, gender, Eastern Cooperative Oncology Group (ECOG) performance score, histology, interval from lung cancer diagnosis until irradiation of bone metastases, visceral metastases, additional bone metastases, type and number of irradiated sites, pathological fracture, upfront surgery and previous systemic treatment were evaluated for potential associations with survival. Those factors that were significant (P<0.05) or showed a trend (P≤0.10) on multivariate analysis were used to create the scoring system.
On multivariate analysis, ECOG performance score was significant (risk ratio: 2.77, P<0.001), and age showed a trend (risk ratio: 1.34, P=0.10). The following scoring points were assigned: age ≤65 years =1 point, age ≥66 years =0 points, ECOG performance score of 0-1 =1 point, and ECOG performance score of ≥2 =0 points. Three prognostic groups were obtained: 0 points (n=38), 1 point (n=71) and 2 points (n=44). Six-month survival rates were 21%, 41% and 75%, 12-month survival rates 7%, 27% and 56% (P<0.001).
This scoring system can help estimate the remaining lifespan of lung cancer patients to be irradiated for bone metastases and will contribute to the personalization of their treatment.
在设计个性化治疗方案时，应考虑转移性肺癌患者的剩余寿命。为便于估计肺癌骨转移患者的生存期，创建了一种特定的评分系统。
本回顾性研究纳入了153例接受分次放疗治疗肺癌骨转移且无脊髓压迫的患者。评估年龄、性别、东部肿瘤协作组（ECOG）体能状态评分、组织学类型、从肺癌诊断到骨转移放疗的间隔时间、内脏转移、额外的骨转移、照射部位的类型和数量、病理性骨折、前期手术及既往全身治疗与生存期的潜在关联。多因素分析中具有显著意义（P<0.05）或呈现趋势（P≤0.10）的因素用于创建评分系统。
多因素分析显示，ECOG体能状态评分具有显著意义（风险比：2.77，P<0.001），年龄呈现趋势（风险比：1.34，P=0.10）。分配以下评分：年龄≤65岁=1分，年龄≥66岁=0分，ECOG体能状态评分为0 - 1=1分，ECOG体能状态评分≥2=0分。获得三个预后组：0分（n = 38）、1分（n = 71）和2分（n = 44）。6个月生存率分别为21%、41%和75%，12个月生存率分别为7%、27%和56%（P<0.001）。
该评分系统有助于估计肺癌骨转移患者的剩余寿命，并将有助于其治疗的个性化。
