You are here

Article Text

Article menu
Download PDFPDF
Short report
Palliative radiotherapy: survival prognostic factors - single-centre retrospective cohort study
  1. Sian Cooper1,
  2. Mary Denholm2,3,
  3. Abdul Shawal Malek4,
  4. Jeffrey Arun Rubasingham1 and
  5. David Tsang1
  1. 1 Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, UK
  2. 2 Department of Oncology, Early Cancer Institute, Cambridge, UK
  3. 3 Department of Oncology, Addenbrooke's Hospital, Cambridge, UK
  4. 4 Mount Vernon Cancer Centre, Northwood, UK
  1. Correspondence to Dr Sian Cooper; siancooper1@nhs.net

Abstract

Objective Patients with non-curative malignancy can receive palliative radiotherapy (PR) to alleviate symptoms. However, choosing the right patient to receive PR can be challenging, as some patients may not survive long enough to gain benefit. This study aims to identify prognostic factors for overall survival (OS) and 30-day mortality (30DM) following PR and to test these in a real-world cohort.

Method A retrospectively collected data set of all adults completing PR between 1 August 2018 and 31 December 2018 at a single centre (n=214, Southend University Hospital NHS Foundation Trust, UK) was used to test prognostic factors. Factors such as demographics, tumour primary, treatment area, fractionation regime, performance status (PS), progressive disease (PD), opioid or steroid use and haemoglobin level, as well as overall survival, were collected. Cox regression was used to examine survival predictors, and logistic regression was used to determine the predictive strength of factors for 30DM.

Results Overall 30DM was 14%. There was significantly worse survival in patients with poor PS (HR 1.2406, 95% CI 0.94 to 1.64. p=0.01). Patients with PS 3 had a median OS of 75 days and were more likely to experience 30DM (OR 6.2, 95% CI 1.226 to 45.42, p=0.03). Patients with PD outside of the radiation field (46%, 30 out of 65 documented) had significantly worse OS (HR 5.24, 95% CI 2.19 to 12.5, p<0.001).

Conclusion Poor PS and PD were prognostic of OS and 30DM. Future work should include validation with a prospectively collected cohort.

  • Cancer
  • Clinical decisions
  • Hospital care
  • Prognosis
  • Service evaluation
  • Methodological research

https://doi.org/10.1136/spcare-2024-004810

Statistics from Altmetric.com

Article has an altmetric score of 6

See more details

2 readers on Mendeley

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • X @DrSACooper

    • Contributors SC designed the study and collected all data. Analyses were conducted by SC. SC wrote the manuscript. All authors read and approved the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.