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A validated scoring system to identify long-term survivors after radiotherapy for metastatic spinal cord compression

Ein validiertes Scoring-System zur Identifizierung von Langzeitüberlebenden nach Strahlentherapie bei metastatisch bedingter Rückenmarkskompression

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Abstract

Purpose

This study aimed to develop and validate a scoring system to identify long-term survivors after conventional radiotherapy (RT) for metastatic spinal cord compression (MSCC).

Patients and methods

Data from 1,125 patients who had received long-course RT for MSCC were included in this study. Of these patients, 344 survived for over 12 months and 781 died within a year following RT. Based on differences between the distributions of patient characteristics in the two groups, a scoring system was developed. Scores ranged from 0 to 18 points and 15 points was selected as the cutoff for identifying long-term survivors. Data from the 1,125 long-course RT patients (test group) were compared to data from 773 patients receiving short-course RT (validation group).

Results

A score of ≥ 15 points was associated with a 94 % proportion of long-term survivors. The 15-point cutoff resulted in a specificity of 98 % and a positive predictive value of 94 % for identification of long-term surviving patients. The proportions of long-term survivors for each scoring point in the validation group were very similar to those in the test group.

Conclusion

This new scoring system enabled identification of long-term survivors after RT for MSCC with very high specificity and positive predictive value. The score proved to be valid and reproducible.

Zusammenfassung

Hintergrund

Ziel dieser Studie war es, ein Scoring-System zu entwickeln und zu validieren, um Langzeitüberlebende nach konventioneller Strahlentherapie bei metastatisch bedingter Rückenmarkskompression (MSCC) identifizieren zu können.

Patienten und Methoden

Daten von 1125 Patienten, die eine Langzeitbestrahlung bei MSCC erhielten, wurden in diese Studie eingeschlossen. Länger als 1 Jahr überlebten 344 Patienten, 781 Patienten waren innerhalb eines Jahres verstorben. Basierend auf der Differenz hinsichtlich der Verteilung der Patientencharakteristika zwischen den beiden Gruppen wurde ein Scoring-System entwickelt. Die Scoring-Werte betrugen 0 bis 18 Punkte. Um Langzeitüberlebende zu identifizieren, wurden 15 Punkte als Grenze gewählt. Die Daten der 1125 Patienten, die eine Langzeitbestrahlung bei MSCC erhielten (Testgruppe), wurden mit den Daten von 773 kurzzeitbestrahlten Patienten (Validierungsgruppe) verglichen.

Ergebnisse

Bei einem Score von ≥ 15 Punkten betrug der Anteil der Langzeitüberlebenden 94 %. Bei einer Grenze von 15 Punkten ergaben sich eine Spezifität von 98 % und ein positiver prädiktiver Wert von 94 %, um Langzeitüberlebende zu identifizieren. Der Anteil der Langzeitüberlebenden der Validierungsgruppe war bei jedem Punktwert des Scoring-Systems den entsprechenden Ergebnissen in der Testgruppe sehr ähnlich.

Schlussfolgerung

Dieses neue Scoring-System ermöglicht die Identifizierung von Langzeitüberlebenden nach RT bei MSCC mit einer sehr hohen Spezifität und einem sehr hohen positiven prädiktiven Wert. Der Score erwies sich als valide und reproduzierbar.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Lubeck, Ratzeburger Allee 160, 23538, Lubeck, Germany

    D. Rades M.D.

  2. Department of Radiation Oncology, Dr. Bernard Verbeeten Institute, Tilburg, Netherlands

    T. Veninga

  3. Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany

    A. Bajrovic

  4. Department of Radiation Oncology, Hannover Medical University, Hannover, Germany

    J.H. Karstens

  5. Department of Radiation Oncology, Mayo Clinic Scottsdale, Arizona, U.S.A.

    S.E. Schild

Authors
  1. D. Rades M.D.
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  2. T. Veninga
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  3. A. Bajrovic
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  4. J.H. Karstens
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  5. S.E. Schild
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Correspondence to D. Rades M.D..

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Rades, D., Veninga, T., Bajrovic, A. et al. A validated scoring system to identify long-term survivors after radiotherapy for metastatic spinal cord compression. Strahlenther Onkol 189, 462–466 (2013). https://doi.org/10.1007/s00066-013-0342-1

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  • DOI: https://doi.org/10.1007/s00066-013-0342-1

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