Predicting the risk of disease recurrence and death following curative-intent radiotherapy for non-small cell lung cancer: the development and validation of two scoring systems from a large multicentre UK cohort
AffiliationWythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
MetadataShow full item record
AbstractAims: There is a paucity of evidence on which to produce recommendations on neither the clinical nor the imaging follow-up of lung cancer patients after curative-intent radiotherapy. In the 2019 National Institute for Health and Care Excellence lung cancer guidelines, further research into risk-stratification models to inform follow-up protocols was recommended. Materials and methods: A retrospective study of consecutive patients undergoing curative-intent radiotherapy for non-small cell lung cancer from 1 October 2014 to 1 October 2016 across nine UK trusts was carried out. Twenty-two demographic, clinical and treatment-related variables were collected and multivariable logistic regression was used to develop and validate two risk-stratification models to determine the risk of disease recurrence and death. Results: In total, 898 patients were included in the study. The mean age was 72 years, 63% (562/898) had a good performance status (0-1) and 43% (388/898), 15% (134/898) and 42% (376/898) were clinical stage I, II and III, respectively. Thirty-six per cent (322/898) suffered disease recurrence and 41% (369/898) died in the first 2 years after radiotherapy. The ASSENT score (age, performance status, smoking status, staging endobronchial ultrasound, N-stage, T-stage) was developed, which stratifies the risk for disease recurrence within 2 years, with an area under the receiver operating characteristic curve (AUROC) for the total score of 0.712 (0.671-0.753) and 0.72 (0.65-0.789) in the derivation and validation sets, respectively. The STEPS score (sex, performance status, staging endobronchial ultrasound, T-stage, N-stage) was developed, which stratifies the risk of death within 2 years, with an AUROC for the total score of 0.625 (0.581-0.669) and 0.607 (0.53-0.684) in the derivation and validation sets, respectively. Conclusions: These validated risk-stratification models could be used to inform follow-up protocols after curative-intent radiotherapy for lung cancer. The modest performance highlights the need for more advanced risk prediction tools.
CitationEvison M, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, et al. Predicting the Risk of Disease Recurrence and Death Following Curative-intent Radiotherapy for Non-small Cell Lung Cancer: The Development and Validation of Two Scoring Systems From a Large Multicentre UK Cohort. Clin Oncol (R Coll Radiol). 2020.
- A comparison of machine learning methods for predicting recurrence and death after curative-intent radiotherapy for non-small cell lung cancer: Development and validation of multivariable clinical prediction models.
- Authors: Hindocha S, Charlton TG, Linton-Reid K, Hunter B, Chan C, Ahmed M, Robinson EJ, Orton M, Ahmad S, McDonald F, Locke I, Power D, Blackledge M, Lee RW, Aboagye EO
- Issue date: 2022 Mar
- The Quality of Curative-intent Radiotherapy for Non-small Cell Lung Cancer in the UK.
- Authors: McAleese J, Baluch S, Drinkwater K
- Issue date: 2015 Sep
- Predicting survival following surgical resection of lung cancer using clinical and pathological variables: The development and validation of the LNC-PATH score.
- Authors: Balata H, Foden P, Edwards T, Chaturvedi A, Elshafi M, Tempowski A, Teng B, Whittemore P, Blyth KG, Kidd A, Ellames D, Flint LA, Robson J, Teh E, Jones R, Batchelor T, Crosbie P, Booton R, Evison M
- Issue date: 2018 Nov
- Population-based analysis of curative therapies in stage II non-small cell lung cancer: the role of radiotherapy in medically inoperable patients.
- Authors: Moore S, Leung B, Wu J, Ho C
- Issue date: 2020 Jan 30
- Outcomes treating stage III non-small cell lung carcinoma with curative-intent radiotherapy and concurrent carboplatin-paclitaxel chemotherapy.
- Authors: Trinh H, Pinkham MB, Lehman M, Zarate D, Dauth M, McGrath M, McCaffrey E, Mai GT, Horwood K
- Issue date: 2016 Jul