Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life.

CCI, Charlson-Deyo comorbidity index ECOG-PS, Eastern Cooperative Oncology Group performance status EMR, Electronical medical records KPS, Karnofsky performance score METSSS score METSSS, Metastasis location elderly/age tumor primary sex sickness/comorbidity and site of radiotherapy NCDB, National Cancer Data Base Palliative RT, Radiation therapy Radiotherapy Survival prediction TEACHH, Type of cancer ECOG age prior palliative chemotherapy, prior hospitalizations and hepatic metastasis TPS, Treatment planning system USZ, University Hospital Zurich

Journal

Clinical and translational radiation oncology
ISSN: 2405-6308
Titre abrégé: Clin Transl Radiat Oncol
Pays: Ireland
ID NLM: 101713416

Informations de publication

Date de publication:
May 2022
Historique:
received: 19 01 2022
revised: 03 04 2022
accepted: 10 04 2022
entrez: 2 5 2022
pubmed: 3 5 2022
medline: 3 5 2022
Statut: epublish

Résumé

Choosing the right treatment for the right patient in a setting of metastatic cancer disease remains a challenge. To facilitate clinical decision-making, predictive tools have been developed to personalize treatment. Here, we aim to assess the use of the recently proposed "METSSS score" as a prognostic tool for overall survival of cancer patients after palliative radiotherapy in the last phase of life. All patients treated with palliative radiotherapy at the end-of-life at the Department of Radiation Oncology of the University Hospital Zurich between January 2010 and December 2019 were included in this study. Data on demographics, diagnosis, treatment and comorbidities was extracted from the treatment planning and the electronical medical records system. To statistically assess the validity of the "METSSS score", the mortality risk score was calculated, followed by stratification of all patients to prognostic risk groups. The prediction of the 1-year overall survival estimates was subsequently calculated. Over the past decade, 274 patients have received palliative radiotherapy during the end-of-life period. One third of patients was female (34%, n = 93). The most frequent primary tumor was lung cancer (n = 121, 44%), and 55% of patients (n = 152) had no comorbidities according to the Charlson-Deyo comorbidity index. The most common radiotherapy site was the brain and eye region (42%, n = 115). The median actual overall survival of all patients was 40 days from the start of radiotherapy. The "METSSS score" survival model predicted that 269 patients (98.1%) belong into the high-risk, four patients (1.5%) into the medium-risk, and one patient (0.4%) into the low-risk group. The predicted median 1-year overall survival was 10%. The METSSS score correctly predicted the survival of our end-of-life patient cohort by assigning them into the highest risk category, and it can therefore serve as a decision-making tool when assigning patient to symptomatic radiotherapy.

Sections du résumé

Introduction and background UNASSIGNED
Choosing the right treatment for the right patient in a setting of metastatic cancer disease remains a challenge. To facilitate clinical decision-making, predictive tools have been developed to personalize treatment. Here, we aim to assess the use of the recently proposed "METSSS score" as a prognostic tool for overall survival of cancer patients after palliative radiotherapy in the last phase of life.
Methods UNASSIGNED
All patients treated with palliative radiotherapy at the end-of-life at the Department of Radiation Oncology of the University Hospital Zurich between January 2010 and December 2019 were included in this study. Data on demographics, diagnosis, treatment and comorbidities was extracted from the treatment planning and the electronical medical records system. To statistically assess the validity of the "METSSS score", the mortality risk score was calculated, followed by stratification of all patients to prognostic risk groups. The prediction of the 1-year overall survival estimates was subsequently calculated.
Results UNASSIGNED
Over the past decade, 274 patients have received palliative radiotherapy during the end-of-life period. One third of patients was female (34%, n = 93). The most frequent primary tumor was lung cancer (n = 121, 44%), and 55% of patients (n = 152) had no comorbidities according to the Charlson-Deyo comorbidity index. The most common radiotherapy site was the brain and eye region (42%, n = 115). The median actual overall survival of all patients was 40 days from the start of radiotherapy. The "METSSS score" survival model predicted that 269 patients (98.1%) belong into the high-risk, four patients (1.5%) into the medium-risk, and one patient (0.4%) into the low-risk group. The predicted median 1-year overall survival was 10%.
Discussion UNASSIGNED
The METSSS score correctly predicted the survival of our end-of-life patient cohort by assigning them into the highest risk category, and it can therefore serve as a decision-making tool when assigning patient to symptomatic radiotherapy.

Identifiants

DOI: 10.1016/j.ctro.2022.04.005 PMID: 35496816 PMC: PMC9038557
pubmed: 35496816
doi: 10.1016/j.ctro.2022.04.005
pii: S2405-6308(22)00028-3
pmc: PMC9038557
doi:

Types de publication

Journal Article

Langues

eng

Pagination

107-111

Informations de copyright

© 2022 The Authors.

Déclaration de conflit d'intérêts

NA received research support from ViewRay, BrainLab, SNF, the Swiss Cancer League, the Staffanini Foundation, and received honoraria from ViewRay, AstraZeneca, BrainLab, and Debiopharm.

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Auteurs

Sebastian M Christ (SM)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Markus Schettle (M)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Jonas Willmann (J)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Maiwand Ahmadsei (M)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Annina Seiler (A)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

David Blum (D)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Matthias Guckenberger (M)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Nicolaus Andratschke (N)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Caroline Hertler (C)

Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Classifications MeSH