Recursive Partitioning Analysis Index Is Predictive for Overall Survival in Patients Undergoing Spine Stereotactic Body Radiation Therapy for Spinal Metastases
| Autor: | S. Soeder, Shlomo A. Koyfman, Lisa Rybicki, Lilyana Angelov, Toufik Djemil, Samuel T. Chao, John H. Suh, Chandana A. Reddy, Neil M. Woody |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Cancer Research Time Factors Adolescent Stereotactic body radiation therapy medicine.medical_treatment Recursive partitioning Radiosurgery Radiation Tolerance Young Adult Text mining Prostate Humans Medicine Radiology Nuclear Medicine and imaging Karnofsky Performance Status Child Aged Aged 80 and over Spinal Neoplasms Radiation business.industry Melanoma Decision Trees Histology Middle Aged Prognosis medicine.disease Survival Analysis Radiation therapy medicine.anatomical_structure Oncology Multivariate Analysis Female Sarcoma business Nuclear medicine Follow-Up Studies |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 82:1738-1743 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2011.02.019 |
| Popis: | To generate a prognostic index using recursive partitioning analysis (RPA) for patients undergoing spine stereotactic body radiation therapy (sSBRT) for spinal metastases (sMet).From an institutional review board-approved database, 174 patients were treated for sMet with sSBRT between February 2006 and August 2009. Median dose was 14 Gy (range, 8-24 Gy), typically in a single fraction (range, 1-5). Kaplan-Meier analysis was performed to detect any correlation between survival and histology. Histologies were divided into favorable (breast and prostate), radioresistant (renal cell, melanoma and sarcoma), and other (all other histologies). RPA was performed to identify any association of the following variables with overall survival (OS) following sSBRT: histology, gender, age, Karnofsky performance status (KPS), control of primary, extraosseous metastases, time from primary diagnosis (TPD), dose of sSBRT (≤14 Gy vs.14 Gy), extent of spine disease (epidural only, bone and epidural, bone only), upfront or salvage treatment, presence of paraspinal extension, and previous surgery.Median follow-up was 8.9 months. Median OS time from sSBRT was 10.7 months. Median OS intervals for favorable histologies were 14 months, 11.2 months for radioresistant histologies, and 7.3 months for other histologies (p = 0.02). RPA analysis resulted in three classes (p0.0001). Class 1 was defined as TPD of30 months and KPS of70; Class 2 was TPD of30 months and KPS of ≤70 or a TPD of ≤30 months and age70 years old; Class 3 was TPD of ≤30 months and age ≥70 years old. Median OS was 21.1 months for Class 1 (n = 59), 8.7 months for Class 2 (n = 104), and 2.4 months for Class 3 (n = 11).sSBRT patients treated for sMet have a wide variability in OS. We developed an RPA classification system that is predictive of OS. While many patients are treated for palliation of pain or to avoid symptomatic progression, this index may be used to predict which patients may benefit most from sSBRT. |
| Databáze: | OpenAIRE |
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