External validation of a prognostic model estimating the survival of patients with recurrent high-grade gliomas after reirradiation
External validation of a prognostic model estimating the survival of patients with recurrent high-grade gliomas after reirradiation
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DOI：
10.1016/j.prro.2014.10.001
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发表时间：
2015-05-01
影响因子：
3.3
通讯作者：
Baumert, Brigitta G.
中科院分区：
文献类型：
--
作者：
Mueller, Klaus;Henke, Guido;Baumert, Brigitta G.
目的：我们的目的是验证一个有争议的预后模型复发性恶性胶质瘤患者的生存后，再照射与一个独立的，多中心patient coherent.Methods和材料：共165恶性胶质瘤患者进行了再照射在4个不同的机构在1994年和2012年之间。22例患者预后良好（评分1），44例患者预后中等（评分2），99例患者预后不良（评分3或4）。采用四种统计学方法验证预后模型：首先，通过视觉比较各自的Kaplan-Meier图，比较构建队列和验证队列中根据预后组的生存率。其次，通过计算每个预后组的死亡风险比来量化区分，其中最差预后组作为参考。通过校准图评估再照射后12个月时间点的校准。最后，我们比较了预测性能的分数和一个假设的预后模型忽略所有的预测变量随着时间的推移，通过预测误差curve. Results：在视觉验证，生存曲线的3个患者组良好，中度，和穷人的prosses很好地相互分离。在预后良好、中等和不良的患者组中，再照射后的中位生存率分别为17.9、9.0和7.7个月。风险比证实了令人满意的区分度。校准是令人满意的所有和最准确的最坏的预后组。与"零模型"相比，该评分改善了预后性能。"结论：我们成功地验证了一个多中心的，独立的数据集恶性胶质瘤患者再照射后的生存预后模型。该模型具有可靠性高、易于操作等优点，可用于个性化的患者咨询和临床决策。(C)2015年美国放射肿瘤学会。爱思唯尔公司出版All rights reserved.
Purpose: We aimed to validate a controversial prognostic model for the survival of relapsed malignant glioma patients after reirradiation with an independent, multicentric patient cohort.Methods and materials: A total of 165 malignant glioma patients underwent reirradiation at 4 different institutions between 1994 and 2012. Twenty- two patients had a good (score 1), 44 had a moderate (score 2), and 99 had a poor prognosis (score 3 or 4). Four statistical methodswere used to validate the prognostic model: First, we compared survival according to prognostic group in the construction and the validation cohort by visual comparison of the respective Kaplan-Meier plots. Second, discrimination was quantified by calculating hazard ratios for death for each prognostic group, with the worst prognostic group serving as the reference. Calibration was assessed by a calibration plot for the time point 12months after reirradiation. Finally, we compared the predictive performance of the score and a hypothetical prognostic model ignoring all predictor variables over time by means of a prediction error curve.Results: On visual validation, the survival curves of the 3 patient groups with good, moderate, and poor prognoses nicely separated from each other. Median survival rates after reirradiation were 17.9, 9.0, and 7.7 months in the patient groups with good, moderate, and poor prognosis, respectively. Hazard ratios confirmed satisfactory discrimination. Calibration was satisfactory for all and most accurate for the worst prognostic group. The score improved the prognostic performance in comparison to the "zero-model."Conclusions: We successfully validated a prognostic model for the survival of malignant glioma patients after reirradiation with a multicentric, independent dataset. Being reliable and easy to handle, the model can be useful in personalized patient counseling and clinical decision-making. (C) 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.