Garrett Jensen1, Chad Tang2, Kenneth R Hess3, Andrew J Bishop2, Hubert Y Pan2, Jing Li2, James N Yang4, Nizar M Tannir5, Behrang Amini6, Claudio Tatsui7, Laurence Rhines7, Paul D Brown2, Amol J Ghia2. 1. Baylor College of Medicine, Houston, Texas, USA. 2. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 3. Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 4. Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 5. Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 6. Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 7. Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Abstract
PURPOSE: We sought to validate the Prognostic Index for Spinal Metastases (PRISM), a scoring system that stratifies patients into subgroups by overall survival.Methods and materials: The PRISM was previously created from multivariate Cox regression with patients enrolled in prospective single institution trials of stereotactic spine radiosurgery (SSRS) for spinal metastasis. We assess model calibration and discrimination within a validation cohort of patients treated off-trial with SSRS for metastatic disease at the same institution. RESULTS: The training and validation cohorts consisted of 205 and 249 patients respectively. Similar survival trends were shown in the 4 PRISM. Survival was significantly different between PRISM subgroups (P<0.0001). C-index for the validation cohort was 0.68 after stratification into subgroups. CONCLUSIONS: We internally validated the PRISM with patients treated off-protocol, demonstrating that it can distinguish subgroups by survival, which will be useful for individualizing treatment of spinal metastases and stratifying patients for clinical trials.
PURPOSE: We sought to validate the Prognostic Index for Spinal Metastases (PRISM), a scoring system that stratifies patients into subgroups by overall survival.Methods and materials: The PRISM was previously created from multivariate Cox regression with patients enrolled in prospective single institution trials of stereotactic spine radiosurgery (SSRS) for spinal metastasis. We assess model calibration and discrimination within a validation cohort of patients treated off-trial with SSRS for metastatic disease at the same institution. RESULTS: The training and validation cohorts consisted of 205 and 249 patients respectively. Similar survival trends were shown in the 4 PRISM. Survival was significantly different between PRISM subgroups (P<0.0001). C-index for the validation cohort was 0.68 after stratification into subgroups. CONCLUSIONS: We internally validated the PRISM with patients treated off-protocol, demonstrating that it can distinguish subgroups by survival, which will be useful for individualizing treatment of spinal metastases and stratifying patients for clinical trials.
Authors: Chad Tang; Kenneth Hess; Andrew J Bishop; Hubert Y Pan; Eva N Christensen; James N Yang; Nizar Tannir; Behrang Amini; Claudio Tatsui; Laurence Rhines; Paul Brown; Amol Ghia Journal: Int J Radiat Oncol Biol Phys Date: 2015-05-10 Impact factor: 7.038
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