Abstract
An Observational Study of the Prognosis of Inpatients Evaluated for Palliative Radiation Therapy
International journal of radiation oncology, biology, physics, Vol.102(3 Suppl), pp.S167-S167
11/01/2018
DOI: 10.1016/j.ijrobp.2018.07.029
Abstract
Purpose/Objective(s)
To determine the survival of inpatients evaluated for palliative RT in the context of low-and-middle-income countries, where resource constraints and waiting lines for treatment are common.
Materials/Methods
We conducted a prospective observational study aiming to assess the prognosis of inpatients evaluated for palliative radiation therapy at a large academic cancer center in Brazil. Patients were eligible if they had an inpatient evaluation request for palliative RT. We applied the Palliative Prognostic Index (PPI) and the Survival Prediction Score using Number of Risk Factors (NRF). Primary endpoint was overall survival (OS). Secondary endpoints were survival according to PPI and NRF. This study is registered with clinical trials.gov, identifier NCT02312791.
Results
Between November 2014 and December 2015, we accessed 530 patients for eligibility. Four hundred twenty-four patients were considered eligible, of which 333 consented and were enrolled. At the time of data analysis, 77% of the patients had died. Median age was 58 years (range 18-87 years). Median KPS was 60, with 65% of the patients with a KPS less than 70. The most common reason for radiation therapy evaluation was tumor bleeding (17%) and the most common primary tumor site was lung (20%). Median survival for the entire cohort was 73 days (95% CI, 59 to 92 days). PPI could define subgroups with different survival: PPI ≤2 had a median survival of 120 days; PPI 2.5 to 4 had a median survival of 55 days (HR 1.84; 95% CI, 1.07 to 3.16); PPI > 4 had a median survival of 39 days (HR 3.45; 95% CI, 2.07 to 5.74) (p<.0001). NRF could also define subgroups with different survival: NRF 0-1 had a median survival of 129 days; NRF 2 had a median survival of 73 days (HR 1.74; 95% CI 0.89 to 3.38); NRF 3 had a median survival of 40 days (HR 2.95; 95% CI, 1.50 to 5.78) (p<.0001).
Conclusion
Inpatients with palliative RT requests seem to have an overall poor survival. PPI and NRF can define subgroups with different prognosis. These could help hospitals and health care systems to standardize criteria for treatment prioritization and contribute for fairness.
Details
- Title: Subtitle
- An Observational Study of the Prognosis of Inpatients Evaluated for Palliative Radiation Therapy
- Creators
- A.T.C. Chen - Instituto do Câncer do Estado de São PauloG.P. Mauro - Universidade de São PauloF. Gabrielli - Instituto do Câncer do Estado de São PauloC. Chaves - Instituto do Câncer do Estado de São PauloI. Castro - Instituto do Câncer do Estado de São PauloK. Vasconcelos - Instituto do Câncer do Estado de São PauloT. Saraiva - Instituto do Câncer do Estado de São PauloM. Reis - Instituto do Câncer do Estado de São PauloH.D.A. Carvalho - Hospital das Clinicas da Faculdade de Medicina da USP, Sao Paulo, Brazil
- Resource Type
- Abstract
- Publication Details
- International journal of radiation oncology, biology, physics, Vol.102(3 Suppl), pp.S167-S167
- DOI
- 10.1016/j.ijrobp.2018.07.029
- ISSN
- 0360-3016
- eISSN
- 1879-355X
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 11/01/2018
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984920699602771
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