Journal article
External validation of life expectancy prognostic models in patients evaluated for palliative radiotherapy at the end‐of‐life
Cancer medicine (Malden, MA), v 9(16), pp 5781-5787
Aug 2020
PMID: 32592315
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
The TEACHH and Chow models were developed to predict life expectancy (LE) in patients evaluated for palliative radiotherapy (PRT). We sought to validate the TEACHH and Chow models in patients who died within 90 days of PRT consultation.
Methods
A retrospective review was conducted on patients evaluated for PRT from 2017 to 2019 who died within 90 days of consultation. Data were collected for the TEACHH and Chow models; one point was assigned for each adverse factor. TEACHH model included: primary site of disease, ECOG performance status, age, prior palliative chemotherapy courses, hospitalization within the last 3 months, and presence of hepatic metastases; patients with 0‐1, 2‐4, and 5‐6 adverse factors were categorized into groups (A, B, and C). The Chow model included non‐breast primary, site of metastases other than bone only, and KPS; patients with 0‐1, 2, or 3 adverse factors were categorized into groups (I, II, and III).
Results
A total of 505 patients with a median overall survival of 2.1 months (IQR: 0.7‐2.6) were identified. Based on the TEACHH model, 10 (2.0%), 387 (76.6%), and 108 (21.4%) patients were predicted to live >1 year, >3 months to ≤1 year, and ≤3 months, respectively. Utilizing the Chow model, 108 (21.4%), 250 (49.5%), and 147 (29.1%) patients were expected to live 15.0, 6.5, and 2.3 months, respectively.
Conclusion
Neither the TEACHH nor Chow model correctly predict prognosis in a patient population with a survival <3 months. A better predictive tool is required to identify patients with short LE.
In patients who died within 90 days of consultation for palliative radiotherapy, the TEACHH and Chow models inadequately identified patients at risk of short‐term mortality. Better prognostic models are required to minimize use of unnecessary oncologic treatments among patients seen at the end‐of‐life.
Metrics
Details
- Title
- External validation of life expectancy prognostic models in patients evaluated for palliative radiotherapy at the end‐of‐life
- Creators
- Adrianna E. Mojica-Márquez - Universidad Central del Caribe School of MedicineJoshua L. Rodríguez-López - University of Pittsburgh School of MedicineAnkur K. Patel - UPMC Hillman Cancer CenterDiane C. Ling - UPMC Hillman Cancer CenterMalolan S. Rajagopalan - Mount Carmel HealthSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Cancer medicine (Malden, MA), v 9(16), pp 5781-5787
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- Shadyside Hospital Foundation
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000543246200001
- Scopus ID
- 2-s2.0-85087207239
- Other Identifier
- 991021897266404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology