Prognostic Factors Influencing Survival and a Treatment Pattern Analysis of Conventional Palliative Radiotherapy for Patients with Bone Metastases
| Autor: | Ofelia Șuteu, Nicolae Todor, Patricia Ignat, Radu-Mihai Ignat |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty overall survival medicine.medical_treatment conventional palliative radiotherapy Bone Neoplasms Logistic regression Article bone metastases Palliative radiotherapy Internal medicine medicine Humans Medical prescription RC254-282 business.industry Proportional hazards model Palliative Care Hazard ratio Neoplasms. Tumors. Oncology. Including cancer and carcinogens prognostic factors Odds ratio Prognosis Radiation therapy Regimen Radiation Oncology multiple fraction radiotherapy single fraction radiotherapy Dose Fractionation Radiation business |
| Zdroj: | Current Oncology Current Oncology, Vol 28, Iss 331, Pp 3876-3890 (2021) Volume 28 Issue 5 Pages 331-3890 |
| ISSN: | 1718-7729 |
| DOI: | 10.3390/curroncol28050331 |
| Popis: | Background: Treatment indication for bone metastases is influenced by patient prognosis. Single-fraction radiotherapy (SFRT) was proven equally effective as multiple fractionation regimens (MFRT) but continues to be underused. Objective: Primary objectives: (a) to identify prognostic factors for overall survival and (b) to analyze treatment patterns of palliative radiotherapy (proportion of SFRT indication and predictive factors of radiotherapy regimen) for bone metastases. Methods: 582 patients with bone metastases who underwent conventional radiotherapy between January 1st 2014–31 December 2017 were analyzed. The Cox proportional hazard model was used to identify predictors of overall survival. For the treatment pattern analysis, 677 radiotherapy courses were evaluated. The logistic regression model was used to identify potential predictors of radiotherapy regimen. Results: The 3-year overall survival was 15%. Prognostic factors associated with poor overall survival were multiple bone metastases [hazard ratio (HR = 5.4)], poor performance status (HR = 1.5) and brain metastases (HR = 1.37). SFRT prescription increased from 41% in 2017 to 51% in 2017. Predictors of SFRT prescription were a poor performance status [odds ratio (OR = 0.55)], lung (OR = 0.49) and urologic primaries (OR = 0.33) and the half-body lower site of irradiation (OR = 0.59). Spinal metastases were more likely to receive MFRT (OR = 2.09). Conclusions: Based on the prognostic factors we identified, a selection protocol for patients candidates for palliative radiotherapy to bone metastases could be established, in order to further increase SFRT prescription in our institution. |
| Databáze: | OpenAIRE |
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