Over the last two decades, while there has been an increase in the use of curative treatment for non-small cell lung cancer (NSCLC), significant patterns of radiotherapy underutilisation persist across Australia and internationally [1,2]. One strategy for addressing such variation is the development of a survival prediction model that integrates individual, medical and environmental factors unaccounted for by guidelines that commonly influence treatment decisions. This would have the potential to objectively evaluate treatment benefits in individual patients to facilitate shared decision-making, tailor patient management and...
Methods and materials
Data from inoperable stage I-III NSCLC patients diagnosed from 1/1/2016-31/12/2017 were retrospectively collected from three radiation oncology clinics. The development cohort comprised patients from South Western Sydney Local Health District (SWSLHD). The validation cohort included patients from Blacktown Cancer and Haematology Centre (BCHC) and Illawarra Cancer Care Centre (ICCC).
Data and statistical analysis
Patient, tumour and treatment-related variables were selected for model inclusion using univariate and multivariate analysis. Cox proportional hazards regression was used to develop a 2-year survival prediction model in one clinic...
The characteristics of the study population are summarised in Table 1. [Fig 1] The SWSLHD population consisted of 157 patients in the overall cohort and 117 patients in the radiotherapy cohort. At the censor date, 45.9% and 47.9% of patients were alive in the overall and radiotherapy cohorts respectively.
The SWSM variables consisted of diffusing capacity of the lung for carbon monoxide, T stage and treatment intent. The R-SWSM included overall stage, tumour lobe and treatment intent. The SWSM and R-SWSM yielded c-indexes respectively of...
To our knowledge, this study is the first to develop and validate survival prediction models in a cohort of inoperable stage I-III NSCLC patients irrespective of treatment intent. Two models of 2-year survival were developed and performed with moderate discrimination. Novel variables included in the models were tumour lobe and treatment intent. Further validation is needed in a larger patient cohort.
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