Assessing the Utility of a Prognostication Model to Predict 1-Year Mortality in Patients Receiving Radiation Therapy for Spinal Metastases
CitationShi, Diana. 2018. Assessing the Utility of a Prognostication Model to Predict 1-Year Mortality in Patients Receiving Radiation Therapy for Spinal Metastases. Doctoral dissertation, Harvard Medical School.
AbstractBackground Context: Predicting survival outcomes after radiation therapy alone for metastatic disease of the spine is a challenging task that is important to guiding treatment decisions (e.g., determining dose fractionation and intensity). The New England Spinal Metastasis Score (NESMS) was recently introduced and validated in independent cohorts as a tool to predict 1-year survival following surgery for spinal metastases. This metric is composed of 3 factors: pre-operative albumin, ambulatory status, and modified Bauer score, with the total score ranging from 0 to 3.
Purpose: The purpose of this study is to assess the applicability of the NESMS model to predict 1-year survival among patients treated with radiation therapy alone for spinal metastases.
Study Design/Setting: This study is a retrospective analysis.
Patient Sample: This sample included 290 patients who underwent conventional radiation therapy alone for spinal metastases.
Outcome Measures: Patients’ NESMS scores (comprised of ambulatory status, pre-treatment serum albumin, and modified Bauer score) were assessed as well as their 1-year overall survival rates following radiation for metastatic disease of the spine.
Methods: This study is a single-institution retrospective analysis of 290 patients treated with conventional radiation alone for spinal metastases from 2008 to 2013. The predictive value of the NESMS was assessed using multivariable logistic regression modeling, adjusted for potential confounding variables.
Results: This analysis indicated that patients with lower NESMS scores had higher rates of 1-year mortality. Multivariable analysis demonstrated a strong association between lower NESMS scores and lower rates of survival.
Conclusions: The NESMS score is a simple prognostic scheme that requires clinical data that is often readily available and has been validated in independent cohorts of surgical patients. This study serves to validate the utility of the NESMS composite score to predict 1-year mortality in patients treated with radiation alone for spinal metastases.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:41973533