Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life
Introduction and background: Choosing the right treatment for the right patient in a setting of metastatic cancer disease remains a challenge. To facilitate clinical decision-making, predictive tools have been developed to personalize treatment. Here, we aim to assess the use of the recently propose...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630822000283 |
| _version_ | 1828364070240124928 |
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| author | Sebastian M. Christ Markus Schettle Jonas Willmann Maiwand Ahmadsei Annina Seiler David Blum Matthias Guckenberger Nicolaus Andratschke Caroline Hertler |
| author_facet | Sebastian M. Christ Markus Schettle Jonas Willmann Maiwand Ahmadsei Annina Seiler David Blum Matthias Guckenberger Nicolaus Andratschke Caroline Hertler |
| author_sort | Sebastian M. Christ |
| collection | DOAJ |
| description | Introduction and background: Choosing the right treatment for the right patient in a setting of metastatic cancer disease remains a challenge. To facilitate clinical decision-making, predictive tools have been developed to personalize treatment. Here, we aim to assess the use of the recently proposed “METSSS score” as a prognostic tool for overall survival of cancer patients after palliative radiotherapy in the last phase of life. Methods: All patients treated with palliative radiotherapy at the end-of-life at the Department of Radiation Oncology of the University Hospital Zurich between January 2010 and December 2019 were included in this study. Data on demographics, diagnosis, treatment and comorbidities was extracted from the treatment planning and the electronical medical records system. To statistically assess the validity of the “METSSS score”, the mortality risk score was calculated, followed by stratification of all patients to prognostic risk groups. The prediction of the 1-year overall survival estimates was subsequently calculated. Results: Over the past decade, 274 patients have received palliative radiotherapy during the end-of-life period. One third of patients was female (34%, n = 93). The most frequent primary tumor was lung cancer (n = 121, 44%), and 55% of patients (n = 152) had no comorbidities according to the Charlson-Deyo comorbidity index. The most common radiotherapy site was the brain and eye region (42%, n = 115). The median actual overall survival of all patients was 40 days from the start of radiotherapy. The “METSSS score” survival model predicted that 269 patients (98.1%) belong into the high-risk, four patients (1.5%) into the medium-risk, and one patient (0.4%) into the low-risk group. The predicted median 1-year overall survival was 10%. Discussion: The METSSS score correctly predicted the survival of our end-of-life patient cohort by assigning them into the highest risk category, and it can therefore serve as a decision-making tool when assigning patient to symptomatic radiotherapy. |
| first_indexed | 2024-04-14T05:10:48Z |
| format | Article |
| id | doaj.art-4b76165921204baa8b2c026d3d2eda66 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-14T05:10:48Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-4b76165921204baa8b2c026d3d2eda662022-12-22T02:10:35ZengElsevierClinical and Translational Radiation Oncology2405-63082022-05-0134107111Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of lifeSebastian M. Christ0Markus Schettle1Jonas Willmann2Maiwand Ahmadsei3Annina Seiler4David Blum5Matthias Guckenberger6Nicolaus Andratschke7Caroline Hertler8Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Corresponding author at: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandIntroduction and background: Choosing the right treatment for the right patient in a setting of metastatic cancer disease remains a challenge. To facilitate clinical decision-making, predictive tools have been developed to personalize treatment. Here, we aim to assess the use of the recently proposed “METSSS score” as a prognostic tool for overall survival of cancer patients after palliative radiotherapy in the last phase of life. Methods: All patients treated with palliative radiotherapy at the end-of-life at the Department of Radiation Oncology of the University Hospital Zurich between January 2010 and December 2019 were included in this study. Data on demographics, diagnosis, treatment and comorbidities was extracted from the treatment planning and the electronical medical records system. To statistically assess the validity of the “METSSS score”, the mortality risk score was calculated, followed by stratification of all patients to prognostic risk groups. The prediction of the 1-year overall survival estimates was subsequently calculated. Results: Over the past decade, 274 patients have received palliative radiotherapy during the end-of-life period. One third of patients was female (34%, n = 93). The most frequent primary tumor was lung cancer (n = 121, 44%), and 55% of patients (n = 152) had no comorbidities according to the Charlson-Deyo comorbidity index. The most common radiotherapy site was the brain and eye region (42%, n = 115). The median actual overall survival of all patients was 40 days from the start of radiotherapy. The “METSSS score” survival model predicted that 269 patients (98.1%) belong into the high-risk, four patients (1.5%) into the medium-risk, and one patient (0.4%) into the low-risk group. The predicted median 1-year overall survival was 10%. Discussion: The METSSS score correctly predicted the survival of our end-of-life patient cohort by assigning them into the highest risk category, and it can therefore serve as a decision-making tool when assigning patient to symptomatic radiotherapy.http://www.sciencedirect.com/science/article/pii/S2405630822000283METSSS scoreSurvival predictionPalliativeRadiotherapy |
| spellingShingle | Sebastian M. Christ Markus Schettle Jonas Willmann Maiwand Ahmadsei Annina Seiler David Blum Matthias Guckenberger Nicolaus Andratschke Caroline Hertler Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life Clinical and Translational Radiation Oncology METSSS score Survival prediction Palliative Radiotherapy |
| title | Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life |
| title_full | Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life |
| title_fullStr | Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life |
| title_full_unstemmed | Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life |
| title_short | Validation and extension of the METSSS score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life |
| title_sort | validation and extension of the metsss score in a metastatic cancer patient cohort after palliative radiotherapy within the last phase of life |
| topic | METSSS score Survival prediction Palliative Radiotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2405630822000283 |
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