The TEACHH model to predict life expectancy in patients presenting for palliative spine radiotherapy: external validation and comparison with alternate models

Dosani, Maryam; Tyldesley, Scott; Bakos, Brendan; Hamm, Jeremy; Kong, Timothy; Lucas, Sarah; Wong, Johnathan; Liu, Mitchell; Hamilton, Sarah

doi:10.1007/s00520-018-4064-x

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…-10 months reported by Chow et al for the three risk groups based on their training, temporal validation and external validation dataset. In comparison, the median OS of our patients with 0-1, 2-4 and 5-6 TEACHH risk factors were 15.4, 3.5 and 0.6 months respectively; these were similar to the corresponding 19.9, 5 and 1.7 months reported by Krishan et al Similar results of the NRF and TEACHH models were reported by Dosani et al based on a cohort of Canadian patients treated with palliative RT for spinal metastases(14). Of the three NRF factors, only site of disease and metastases were significantly associated with OS.…”

supporting

confidence: 91%

“…The TEACHH model developed by Krishnan et al stratified patients into three prognostic groups based on cancer type, Eastern Cooperative Oncology Group (ECOG) performance status, age, prior palliative chemotherapy, prior hospitalisation and hepatic metastases (11). Both models have been externally validated in several studies, and have shown to be effective tools in the Caucasian population (10,(12)(13)(14). Currently, data on the performance of these models in Asian populations is limited.…”

Section: Introductionmentioning

confidence: 99%

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Improving the prognostication of patients receiving palliative radiotherapy

Sin¹,

Ong²,

Pang³

et al. 2021

Ther Radiol Oncol

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Background: We aim to develop a prognostic model for patients undergoing palliative radiotherapy (RT), and to compare its performance with alternative prognostic models.Methods: A total of 288 patients were prospectively recruited and randomly split into a 60% training cohort and a 40% testing cohort for model development and validation. Prognosticators were identified via Cox regression analyses. Additional parametric survival models with the identified prognosticators included as covariates were fitted. Model fit and discrimination ability of various fitted models were compared to identify the best model. Patients were grouped according to the number of prognostic factors of the NRF model and TEACHH model for comparison.Results: In the training cohort, neutrophil-lymphocyte ratio (NLR) ≥6, inpatient status at start of RT, prior chemotherapy within 3 months of starting RT, and Palliative Performance Scale score ≤50% were independently and adversely associated with OS. Amongst the various models considered, the log-logistic accelerated failure time (AFT) model had the best performance [log-logistic AFT: explained variation R 2

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supporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Improving the prognostication of patients receiving palliative radiotherapy

Sin¹,

Ong²,

Pang³

et al. 2021

Ther Radiol Oncol

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“…Newer therapies such as immunotherapy are emerging, which may alter cancer progression and mortality. While all three prognostic models were developed prior to wide spread use of immunotherapy, it is helpful to note that the Chow NRF model, which was developed among patients seen in 1999, still performs quite well among more contemporary cohorts (19,21,22), who inevitably are being exposed to newer systemic agents.…”

Section: Estimating Life Expectancy For Patients and Treatment Recomm...mentioning

confidence: 99%

Defining the radiation oncologist’s role in palliative care and radiotherapy

Lam¹,

Tseng²

2019

Ann. Palliat. Med.

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Radiation oncologists play an important role in the palliative care of advanced cancer patients.The article discusses the various clinical indications of palliative radiation therapy, which include the control of bone pain, acute treatment of cord compression, the control of thoracic and gastrointestinal symptoms.The importance of survival estimates for individualization of radiation therapy regime is elaborated. Besides prescription of radiation treatment, radiation oncologists should also function as primary palliative care providers by assessing and initial management of symptoms and other sources of distress, making prompt referrals to specialists for complex symptom management and contributing to the multidisciplinary palliative care team. Additionally, communication skills, including prognostic disclosure and goals of care discussions, should also be a core competency of radiation oncologists.

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“… [3] , [4] , [5] As such, a number of prognostic models have been developed in order to support improved prognostication and thus better informed treatment decisions. [6] , [7] , [8] , [9] Multiple models have been developed in palliative radiotherapy where the decision to treat and to fractionate may vary with the expected prognosis of the patient.…”

Section: Introductionmentioning

confidence: 99%