Can physicians accurately predict survival time in patients with metastatic cancer? Analysis of RTOG 97-14
Can physicians accurately predict survival time in patients with metastatic cancer? Analysis of RTOG 97-14
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DOI：
10.1089/jpm.2007.0259
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发表时间：
2008-06-01
影响因子：
2.8
通讯作者：
Konski, Andre A.
中科院分区：
文献类型：
--
作者：
Hartsell, William F.;Desilvio, Michelle;Konski, Andre A.
目的：为了确定如果医生预测的生存时间（PSD）是准确的转移性乳腺癌或前列腺癌patients with metastatic breast or prostate cancer.Methods：放射治疗肿瘤组9714（RTOG 9714）是一个随机比较放射治疗计划治疗骨转移。治疗医生分配基线Karnofsky性能评分（KPS），并在研究入组时预测生存期。患者完成了癌症治疗功能评估（FACT）。结果：898例患者符合条件，可进行分析。实际中位生存期为9.3个月。中位PSD为12个月。PSD、KPS和FACT均与实际生存率中度相关。KPS评分较高的患者生存时间较长（882例患者，斯皮尔曼rho = 0.259，p < 0.0001）。618例死亡患者中位生存期为6.5个月（PSD为12个月）。61例（10%）患者的PSD在实际生存1个月内，177例（29%）患者的生存时间比预期长1个月以上，375例（61%）患者的生存时间比预期短1个月以上。对实际总生存期进行单变量分析，将PSD分为4组。对于6个月或更短、小于6个月至小于12个月、12个月和大于12个月的预测生存期，中位实际生存期分别为7.0、7.2和9.7。结论：KPS评分、FACT评分、PSD评分均与实际生存期相关。参与这项研究的医生能够预测哪些患者的生存时间更长，尽管与平均3个月的实际生存期相比，生存预测是乐观的。
Purpose: To determine if physician prediction of survival duration (PSD) is accurate for patients with metastatic breast or prostate cancer.Methods: Radiation Therapy Oncology Group 9714 (RTOG 9714) was a randomized comparison of radiotherapy schedules for treatment of bone metastases. The treating physician assigned a baseline Karnofsky Performance Score (KPS) and predicted survival duration at study entry. Patients completed the Functional Assessment of Cancer Therapy (FACT). These three were compared to actual survival time.Results: Eight hundred ninety-eight patients were eligible and analyzable. Actual median survival was 9.3 months. The median PSD was 12 months. PSD, KPS, and FACT were all moderately correlated with actual survival. Patients with higher KPS had a longer survival time (882 patients, Spearman's rho = 0.259, p < 0.0001). The median survival of the 618 expired patients is 6.5 months (PSD was 12 months). The PSD was within 1 month of actual survival in 61 (10%), with 177 (29%) patients surviving more than 1 month longer than predicted and 375 (61%) surviving more than 1 month less than predicted. A univariate analysis of actual overall survival was performed, dividing the PSD into 4 groups. For predicted survivals of 6 months or less, less than 6 to less than 12 months, 12 months, and more than 12 months, median actual survivals were 7.0, 7.2, 9.7. and 13.5 months (p < 0.0001).Conclusions: KPS, FACT scores, and PSD all are correlated with actual survival. Physicians on this study were able to predict which patients would have longer survival times, although prediction of survival was optimistic compared to actual survival by an average of 3 months.