@article {56, title = {A Validated Prediction Model for Overall Survival From Stage III Non-Small Cell Lung Cancer: Toward Survival Prediction for Individual Patients.}, journal = {Int J Radiat Oncol Biol Phys}, volume = {92}, year = {2015}, month = {2015 Jul 15}, pages = {935-44}, abstract = {

PURPOSE: Although patients with stage III non-small cell lung cancer (NSCLC) are homogeneous according to the TNM staging system, they form a heterogeneous group, which is reflected in the survival outcome. The increasing amount of information for an individual patient and the growing number of treatment options facilitate personalized treatment, but they also complicate treatment decision making. Decision support systems (DSS), which provide individualized prognostic information, can overcome this but are currently lacking. A DSS for stage III NSCLC requires the development and integration of multiple models. The current study takes the first step in this process by developing and validating a model that can provide physicians with a survival probability for an individual NSCLC patient.

METHODS AND MATERIALS: Data from 548 patients with stage III NSCLC were available to enable the development of a prediction model, using stratified Cox regression. Variables were selected by using a bootstrap procedure. Performance of the model was expressed as the c statistic, assessed internally and on 2 external data sets (n=174 and n=130).

RESULTS: The final multivariate model, stratified for treatment, consisted of age, gender, World Health Organization performance status, overall treatment time, equivalent radiation dose, number of positive lymph node stations, and gross tumor volume. The bootstrapped c statistic was 0.62. The model could identify risk groups in external data sets. Nomograms were constructed to predict an individual patient{\textquoteright}s survival probability (www.predictcancer.org). The data set can be downloaded at https://www.cancerdata.org/10.1016/j.ijrobp.2015.02.048.

CONCLUSIONS: The prediction model for overall survival of patients with stage III NSCLC highlights the importance of combining patient, clinical, and treatment variables. Nomograms were developed and validated. This tool could be used as a first building block for a decision support system.

}, keywords = {Age Factors, Aged, Analysis of Variance, Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Carcinoma, Non-Small-Cell Lung, Chemoradiotherapy, Cisplatin, Deoxycytidine, Etoposide, Female, Gemcitabine, Humans, Lung Neoplasms, Male, Middle Aged, Models, Statistical, Neoplasm Staging, Nomograms, Probability, Radiotherapy Dosage, Regression Analysis, Severity of Illness Index, Sex Factors, Vinblastine, Vinorelbine}, issn = {1879-355X}, doi = {10.1016/j.ijrobp.2015.02.048}, author = {Oberije, Cary and De Ruysscher, Dirk and Houben, Ruud and van de Heuvel, Michel and Uyterlinde, Wilma and Deasy, Joseph O and Belderbos, Jose and Dingemans, Anne-Marie C and Rimner, Andreas and Din, Shaun and Lambin, Philippe} } @article {46, title = {Externally validated HPV-based prognostic nomogram for oropharyngeal carcinoma patients yields more accurate predictions than TNM staging.}, journal = {Radiother Oncol}, volume = {113}, year = {2014}, month = {2014 Dec}, pages = {324-30}, abstract = {

PURPOSE: Due to the established role of the human papillomavirus (HPV), the optimal treatment for oropharyngeal carcinoma is currently under debate. We evaluated the most important determinants of treatment outcome to develop a multifactorial predictive model that could provide individualized predictions of treatment outcome in oropharyngeal carcinoma patients.

METHODS: We analyzed the association between clinico-pathological factors and overall and progression-free survival in 168 OPSCC patients treated with curative radiotherapy or concurrent chemo-radiation. A multivariate model was validated in an external dataset of 189 patients and compared to the TNM staging system. This nomogram will be made publicly available at www.predictcancer.org.

RESULTS: Predictors of unfavorable outcomes were negative HPV-status, moderate to severe comorbidity, T3-T4 classification, N2b-N3 stage, male gender, lower hemoglobin levels and smoking history of more than 30 pack years. Prediction of overall survival using the multi-parameter model yielded a C-index of 0.82 (95\% CI, 0.76-0.88). Validation in an independent dataset yielded a C-index of 0.73 (95\% CI, 0.66-0.79. For progression-free survival, the model{\textquoteright}s C-index was 0.80 (95\% CI, 0.76-0.88), with a validation C-index of 0.67, (95\% CI, 0.59-0.74). Stratification of model estimated probabilities showed statistically different prognosis groups in both datasets (p<0.001).

CONCLUSION: This nomogram was superior to TNM classification or HPV status alone in an independent validation dataset for prediction of overall and progression-free survival in OPSCC patients, assigning patients to distinct prognosis groups. These individualized predictions could be used to stratify patients for treatment de-escalation trials.

}, keywords = {Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Chemoradiotherapy, Disease-Free Survival, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Neoplasm Staging, Nomograms, Oropharyngeal Neoplasms, Papillomaviridae, Polymerase Chain Reaction, Predictive Value of Tests, Prognosis, Reproducibility of Results, Severity of Illness Index, Sex Factors, Squamous Cell Carcinoma of Head and Neck, Treatment Outcome}, issn = {1879-0887}, doi = {10.1016/j.radonc.2014.09.005}, author = {Rios Velazquez, Emmanuel and Hoebers, Frank and Aerts, Hugo J W L and Rietbergen, Michelle M and Brakenhoff, Ruud H and Leemans, Ren{\'e} C and Speel, Ernst-Jan and Straetmans, Jos and Kremer, Bernd and Lambin, Philippe} } Error | CancerData.org

Error

The website encountered an unexpected error. Please try again later.