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Development and validation of a recursive partitioning analysis-based pretreatment decision-making tool identifying ideal candidates for spine stereotactic body radiation therapy.

Publication ,  Journal Article
Kowalchuk, RO; Mullikin, TC; Florez, M; De, BS; Spears, GM; Rose, PS; Siontis, BL; Kim, DK; Costello, BA; Morris, JM; Marion, JT; Gao, RW ...
Published in: Cancer
March 15, 2023

BACKGROUND: This study was aimed at developing and validating a decision-making tool predictive of overall survival (OS) for patients receiving stereotactic body radiation therapy (SBRT) for spinal metastases. METHODS: Three hundred sixty-one patients at one institution were used for the training set, and 182 at a second institution were used for external validation. Treatments most commonly involved one or three fractions of spine SBRT. Exclusion criteria included proton therapy and benign histologies. RESULTS: The final model consisted of the following variables and scores: Spinal Instability Neoplastic Score (SINS) ≥ 6 (1), time from primary diagnosis < 21 months (1), Eastern Cooperative Oncology Group (ECOG) performance status = 1 (1) or ECOG performance status > 1 (2), and >1 organ system involved (1). Each variable was an independent predictor of OS (p < .001), and each 1-point increase in the score was associated with a hazard ratio of 2.01 (95% confidence interval [CI], 1.79-2.25; p < .0001). The concordance value was 0.75 (95% CI, 0.71-0.78). The scores were discretized into three groups-favorable (score = 0-1), intermediate (score = 2), and poor survival (score = 3-5)-with 2-year OS rates of 84% (95% CI, 79%-90%), 46% (95% CI, 36%-59%), and 21% (95% CI, 14%-32%), respectively (p < .0001 for each). In the external validation set (182 patients), the score was also predictive of OS (p < .0001). Increasing SINS

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

March 15, 2023

Volume

129

Issue

6

Start / End Page

956 / 965

Location

United States

Related Subject Headings

  • Spine
  • Spinal Neoplasms
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Humans
  • Follow-Up Studies
  • 4206 Public health
  • 3211 Oncology and carcinogenesis
  • 1117 Public Health and Health Services
  • 1112 Oncology and Carcinogenesis
 

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Kowalchuk, R. O., Mullikin, T. C., Florez, M., De, B. S., Spears, G. M., Rose, P. S., … Merrell, K. W. (2023). Development and validation of a recursive partitioning analysis-based pretreatment decision-making tool identifying ideal candidates for spine stereotactic body radiation therapy. Cancer, 129(6), 956–965. https://doi.org/10.1002/cncr.34626
Kowalchuk, Roman O., Trey C. Mullikin, Marcus Florez, Brian S. De, Grant M. Spears, Peter S. Rose, Brittany L. Siontis, et al. “Development and validation of a recursive partitioning analysis-based pretreatment decision-making tool identifying ideal candidates for spine stereotactic body radiation therapy.Cancer 129, no. 6 (March 15, 2023): 956–65. https://doi.org/10.1002/cncr.34626.
Kowalchuk RO, Mullikin TC, Florez M, De BS, Spears GM, Rose PS, Siontis BL, Kim DK, Costello BA, Morris JM, Marion JT, Johnson-Tesch BA, Gao RW, Shiraishi S, Lucido JJ, Trifiletti DM, Olivier KR, Owen D, Stish BJ, Waddle MR, Laack NN, Park SS, Brown PD, Ghia AJ, Merrell KW. Development and validation of a recursive partitioning analysis-based pretreatment decision-making tool identifying ideal candidates for spine stereotactic body radiation therapy. Cancer. 2023 Mar 15;129(6):956–965.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

March 15, 2023

Volume

129

Issue

6

Start / End Page

956 / 965

Location

United States

Related Subject Headings

  • Spine
  • Spinal Neoplasms
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Humans
  • Follow-Up Studies
  • 4206 Public health
  • 3211 Oncology and carcinogenesis
  • 1117 Public Health and Health Services
  • 1112 Oncology and Carcinogenesis