30-Day Mortality Following Palliative Radiotherapy

Vázquez, Miriam; Altabas, Manuel; Moreno, Diana Cristina Rodríguez; Geng, A.; Pérez‐Hoyos, S.; Giralt, Jordi

doi:10.3389/fonc.2021.668481

Cited by 13 publications

(8 citation statements)

References 21 publications

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“…30-day mortality calculated from start of treatment, 30-day mortality calculated from end of treatment, or treatment in the last 30 days of life. Regardless of this study’s limitations and the unique patient selection, the topic of active treatment in the terminal phase of cancer continues to be important for patients and providers alike [ 21 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

30-day mortality in patients treated for brain metastases: extracranial causes dominate

et al. 2022

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Background Established prognostic models, such as the diagnosis-specific graded prognostic assessment, were not designed to specifically address very short survival. Therefore, a brain metastases-specific 30-day mortality model may be relevant. We hypothesized that in-depth evaluation of a carefully defined cohort with short survival, arbitrarily defined as a maximum of 3 months, may provide signals and insights, which facilitate the development of a 30-day mortality model. Methods Retrospective analysis (2011–2021) of patients treated for brain metastases with different approaches. Risk factors for 30-day mortality from radiosurgery or other primary treatment were evaluated. Results The cause of death was unrelated to brain metastases in 61%. Treatment-related death (grade 5 toxicity) did not occur. Completely unexpected death was not observed, e.g. accident, suicide or sudden cardiac death. Logistic regression analysis showed 9 factors associated with 30-day mortality (each assigned 3–6 points) and a point sum was calculated for each patient. The point sum ranged from 0 (no risk factors for death within 30 days present) to 30. The results can be grouped into 3 or 4 risk categories. Eighty-three percent of patients in the highest risk group (> 16 points) died within 30 days, and none survived for more than 2 months. However, many cases of 30-day mortality (more than half) occurred in intermediate risk categories. Conclusion Extracranial tumor progression was the prevailing cause of 30-day mortality and few, if any deaths could be considered relatively unexpected when looking at the complete oncological picture. We were able to develop a multifactorial prediction model. However, the model’s performance was not fully satisfactory and it is not routinely applicable at this point in time, because external validation is needed to confirm our hypothesis-generating findings.

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Section: Discussionmentioning

confidence: 99%

30-day mortality in patients treated for brain metastases: extracranial causes dominate

et al. 2022

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“…Not all patients initially thought to represent suitable candidates for radiotherapy are able to complete their treatment. In a recent study by Vázquez et al, 30-day mortality after palliative radiotherapy was 17.5% [ 21 ]. In the multivariate analysis, male gender, ECOG PS 2–3, gastrointestinal and lung cancer were found to be independent factors related to this endpoint.…”

Section: Discussionmentioning

confidence: 99%

Early death after palliative radiation treatment: 30-, 35- and 40-day mortality data and statistically robust predictors

et al. 2023

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Background This study analyzed mortality after radiotherapy for bone metastases (287 courses). Endpoints such as treatment in the last month of life and death within 30, 35 and 40 days from start of radiotherapy were evaluated. Methods Different baseline parameters including but not limited to blood test results and patterns of metastases were assessed for association with early death. After univariate analyses, multi-nominal logistic regression was employed. Results Of 287 treatment courses, 42 (15%) took place in the last month of life. Mortality from start of radiotherapy was 13% (30-day), 15% (35-day) and 18% (40-day), respectively. We identified three significant predictors of 30-day mortality (performance status (≤ 50, 60–70, 80–100), weight loss of at least 10% within 6 months (yes/no), pleural effusion (present/absent)) and employed these to construct a predictive model with 5 strata and mortality rates of 0–75%. All predictors of 30-day mortality were also associated with both, 35- and 40-day mortality. Conclusion Early death was not limited to the first 30 days after start of radiotherapy. For different cut-off points, similar predictive factors emerged. A model based on three robust predictors was developed.

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“…In prior studies of patients receiving any palliative RT, rates of 30-DM ranged from 10% to 24%. 4 , 13 , 14 , 15 One recent study of patients with brain metastases from any primary site reported a 30-DM of 28%. 16 We observed a lower rate of 30-DM in our cohort, possibly owing to inclusion of those receiving SRS to limited intracranial metastases, representing a population with a better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated With 30-Day Mortality Among Patients Undergoing Radiation Therapy for Brain Metastases

Natesan¹,

Carpenter²,

Giles³

et al. 2023

Advances in Radiation Oncology

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30-Day Mortality Following Palliative Radiotherapy

Cited by 13 publications

References 21 publications

30-day mortality in patients treated for brain metastases: extracranial causes dominate

30-day mortality in patients treated for brain metastases: extracranial causes dominate

Early death after palliative radiation treatment: 30-, 35- and 40-day mortality data and statistically robust predictors

Clinical Factors Associated With 30-Day Mortality Among Patients Undergoing Radiation Therapy for Brain Metastases

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