TY - JOUR
T1 - Improving survival prediction of oesophageal cancer patients treated with external beam radiotherapy for dysphagia
AU - Jeene, Paul M.
AU - Kuijper, Steven C.
AU - van den Boorn, Héctor G.
AU - El Sharouni, Sherif Y.
AU - Braam, Pètra M.
AU - Oppedijk, Vera
AU - Verhoeven, Rob H.A.
AU - Hulshof, Maarten C.C.M.
AU - van Laarhoven, Hanneke W.M.
N1 - Funding Information:
This work was supported by The Dutch Cancer Society, grant number UVA 2014-7000. The authors thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry.
Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022/7
Y1 - 2022/7
N2 - Introduction: The recent POLDER trial investigated the effects of external beam radiotherapy (EBRT) on dysphagia caused by incurable oesophageal cancer. An estimated life expectancy of minimally three months was required for inclusion. However, nearly one-third of the included patients died within three months. The aim of this study was to investigate if the use of prediction models could have improved the physician’s estimation of the patient’s survival. Methods: Data from the POLDER trial (N = 110) were linked to the Netherlands Cancer Registry to retrieve patient, tumour, and treatment characteristics. Two published prediction models (the SOURCE model and Steyerberg model) were used to predict three-month survival for all patients included in the POLDER trial. Predicted survival probabilities were dichotomised and the accuracy, sensitivity, specificity, and the area under the curve (AUC) were used to evaluate the predictive performance. Results: The SOURCE and Steyerberg model had an accuracy of 79% and 64%, and an AUC of 0.76 and 0.60 (p =.017), respectively. The SOURCE model had higher specificity across survival cut-off probabilities, the Steyerberg model had a higher sensitivity beyond the survival probability cut-off of 0.7. Using optimal cut-off probabilities, SOURCE would have wrongfully included 16/110 patients into the POLDER and Steyerberg 34/110. Conclusion: The SOURCE model was found to be a more useful decision aid than the Steyerberg model. Results showed that the SOURCE model could be used for three-month survival predictions for patients that are considered for palliative treatment of dysphagia caused by oesophageal cancer in addition to clinicians’ judgement.
AB - Introduction: The recent POLDER trial investigated the effects of external beam radiotherapy (EBRT) on dysphagia caused by incurable oesophageal cancer. An estimated life expectancy of minimally three months was required for inclusion. However, nearly one-third of the included patients died within three months. The aim of this study was to investigate if the use of prediction models could have improved the physician’s estimation of the patient’s survival. Methods: Data from the POLDER trial (N = 110) were linked to the Netherlands Cancer Registry to retrieve patient, tumour, and treatment characteristics. Two published prediction models (the SOURCE model and Steyerberg model) were used to predict three-month survival for all patients included in the POLDER trial. Predicted survival probabilities were dichotomised and the accuracy, sensitivity, specificity, and the area under the curve (AUC) were used to evaluate the predictive performance. Results: The SOURCE and Steyerberg model had an accuracy of 79% and 64%, and an AUC of 0.76 and 0.60 (p =.017), respectively. The SOURCE model had higher specificity across survival cut-off probabilities, the Steyerberg model had a higher sensitivity beyond the survival probability cut-off of 0.7. Using optimal cut-off probabilities, SOURCE would have wrongfully included 16/110 patients into the POLDER and Steyerberg 34/110. Conclusion: The SOURCE model was found to be a more useful decision aid than the Steyerberg model. Results showed that the SOURCE model could be used for three-month survival predictions for patients that are considered for palliative treatment of dysphagia caused by oesophageal cancer in addition to clinicians’ judgement.
KW - decision aid
KW - external beam radiotherapy
KW - oesophageal cancer
KW - Prediction models
KW - Deglutition Disorders/etiology
KW - Esophageal Neoplasms/complications
KW - Area Under Curve
KW - Humans
KW - Decision Support Techniques
KW - Survival Rate
KW - Netherlands/epidemiology
KW - Palliative Care/methods
UR - http://www.scopus.com/inward/record.url?scp=85131433175&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2022.2079385
DO - 10.1080/0284186X.2022.2079385
M3 - Article
C2 - 35651320
AN - SCOPUS:85131433175
SN - 0284-186X
VL - 61
SP - 849
EP - 855
JO - Acta Oncologica
JF - Acta Oncologica
IS - 7
ER -