Vol 26, No 5 (2021)
Research paper
Published online: 2021-08-16

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The LabBM score is an excellent survival prediction tool in patients undergoing palliative radiotherapy

Carsten Nieder12, Astrid Dalhaug1, Ellinor Haukland12
Rep Pract Oncol Radiother 2021;26(5):740-746.

Abstract

Background and Aim: The prognostic assessment of patients referred for palliative radiotherapy can be conducted by site-specific scores. A quick assessment that would cover the whole spectrum could simplify the working day of clinicians who are not specialists for a particular disease site. This study evaluated a promising score, the LabBM (validated for brain metastases), in patients treated for other indications.     

Materials and methods: The LabBM score was calculated in 375 patients by assigning 1 point each for C-reactive protein and lactate dehydrogenase above the upper limit of normal, and 0.5 points each for hemoglobin, platelets and albumin below the lower limit of normal. Uni- and multivariate analyses were performed.

Results: Median overall survival gradually decreased with increasing point sum (range 25.1–1.1 months). When grouped according to the original three-tiered model, excellent discrimination was found. Patients with 0–1 points had a median survival of 15.7 months. Those with 1.5–2 points had a median survival of 5.8 months. Finally, those with 2.5–3.5 points had a median survival of 3.2 months (all p-values ≤ 0.001).

Conclusion: The LabBM score, which is derived from inexpensive blood tests and easy to use, stratified patients into three very distinct prognostic groups and deserves further validation.

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References

  1. Åsli LM, Myklebust TÅ, Kvaløy SO, et al. Factors influencing access to palliative radiotherapy: a Norwegian population-based study. Acta Oncol. 2018; 57(9): 1250–1258.
  2. Lutz ST. Palliative radiotherapy: history, recent advances, and future directions. Ann Palliat Med. 2019; 8(3): 240–245.
  3. Nieder C, Dalhaug A, Haukland E, et al. Palliative Radiotherapy with or without Additional Care by a Multidisciplinary Palliative Care Team: A Retrospective Comparison. ISRN Oncol. 2014; 2014(4): 715396–2275.
  4. Rautakorpi LK, Mäkelä JM, Seyednasrollah F, et al. Assessing the utilization of radiotherapy near end of life at a Finnish University Hospital: a retrospective cohort study. Acta Oncol. 2017; 56(10): 1265–1271.
  5. Park KR, Lee CG, Tseng YD, et al. Palliative radiation therapy in the last 30 days of life: A systematic review. Radiother Oncol. 2017; 125(2): 193–199.
  6. Giraldo A, Benavente S, Ramos M, et al. Effectiveness of radiotherapy for metastatic spinal cord compression in patients with short life expectancy. Rep Pract Oncol Radiother. 2017; 22(1): 58–63.
  7. Wu SY, Singer L, Boreta L, et al. Palliative radiotherapy near the end of life. BMC Palliat Care. 2019; 18(1): 29.
  8. Anshushaug M, Gynnild MA, Kaasa S, et al. Characterization of patients receiving palliative chemo- and radiotherapy during end of life at a regional cancer center in Norway. Acta Oncol. 2015; 54(3): 395–402.
  9. Nieder C, Mannsåker B, Dalhaug A, et al. The Glasgow prognostic score: Useful information when prescribing palliative radiotherapy. Mol Clin Oncol. 2017; 6(6): 811–816.
  10. Chow E, Abdolell M, Panzarella T, et al. Recursive partitioning analysis of prognostic factors for survival in patients with advanced cancer. Int J Radiat Oncol Biol Phys. 2009; 73(4): 1169–1176.
  11. Angelo K, Dalhaug A, Pawinski A, et al. Survival prediction score: a simple but age-dependent method predicting prognosis in patients undergoing palliative radiotherapy. ISRN Oncol. 2014; 2014: 912865.
  12. Dosani M, Tyldesley S, Bakos B, et al. The TEACHH model to predict life expectancy in patients presenting for palliative spine radiotherapy: external validation and comparison with alternate models. Support Care Cancer. 2018; 26(7): 2217–2227.
  13. Krishnan MS, Epstein-Peterson Z, Chen YH, et al. Predicting life expectancy in patients with metastatic cancer receiving palliative radiotherapy: the TEACHH model. Cancer. 2014; 120(1): 134–141.
  14. Sperduto PW, Mesko S, Li J, et al. Survival in Patients With Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient. J Clin Oncol. 2020; 38(32): 3773–3784.
  15. Nieder C, Mehta MP, Geinitz H, et al. Prognostic and predictive factors in patients with brain metastases from solid tumors: A review of published nomograms. Crit Rev Oncol Hematol. 2018; 126: 13–18.
  16. Jeene PM, de Vries KC, van Nes JGH, et al. Survival after whole brain radiotherapy for brain metastases from lung cancer and breast cancer is poor in 6325 Dutch patients treated between 2000 and 2014. Acta Oncol. 2018; 57(5): 637–643.
  17. Nieder C, Guckenberger M, Gaspar LE, et al. Management of patients with brain metastases from non-small cell lung cancer and adverse prognostic features: multi-national radiation treatment recommendations are heterogeneous. Radiat Oncol. 2019; 14(1): 33.
  18. Sledge GW. Curing Metastatic Breast Cancer. J Oncol Pract. 2016; 12(1): 6–10.
  19. Berghoff AS, Wolpert F, Holland-Letz T, et al. Combining standard clinical blood values for improving survival prediction in patients with newly diagnosed brain metastases-development and validation of the LabBM score. Neuro Oncol. 2017; 19(9): 1255–1262.
  20. Nieder C, Dalhaug A, Pawinski A. External Validation of the LabBM Score in Patients With Brain Metastases. J Clin Med Res. 2019; 11(5): 321–325.
  21. Vuong DA, Rades D, Vo SQ, et al. Extracranial metastatic patterns on occurrence of brain metastases. J Neurooncol. 2011; 105(1): 83–90.
  22. Nieder C, Kämpe TA, Pawinski A, et al. Patient-reported symptoms before palliative radiotherapy predict survival differences. Strahlenther Onkol. 2018; 194(6): 533–538.
  23. Ito K, Nakamura N, Shimizuguchi T, et al. Appropriate endpoints for stereotactic body radiotherapy for bone metastasis: Classification into five treatment groups. Rep Pract Oncol Radiother. 2020; 25(1): 150–153.
  24. Steinmann D, Paelecke-Habermann Y, Geinitz H, et al. Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases. BMC Cancer. 2012; 12: 283.