Predicting the survival of patients with bone metastases treated with radiation therapy: a validation study of the Katag
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RESEARCH
Open Access
Predicting the survival of patients with bone metastases treated with radiation therapy: a validation study of the Katagiri scoring system Hikaru Kubota1,2*, Toshinori Soejima1,3, Nor Shazrina Sulaiman1, Shuhei Sekii1, Yoko Matsumoto1, Yosuke Ota1, Kayoko Tsujino1, Ikuo Fujita4, Takuya Fujimoto4, Masayuki Morishita4, Junichi Ikegaki5, Koji Matsumoto6 and Ryohei Sasaki2
Abstract Background: The selection of radiation therapy dose fractionation schedules for bone metastases is often based on the estimation of life expectancy. Therefore, accurate prognosis prediction is an important issue. It is reported that the Katagiri scoring system can be used to predict the survival of patients with bone metastases. We aimed to assess prognostic factors and validate the Katagiri scoring system in patients who were treated with radiation therapy for bone metastases. Materials/Methods: We retrospectively reviewed data of all patients who were treated with radiation therapy for bone metastases between 2004 and 2013. Age, sex, Karnofsky performance status (KPS), Eastern Cooperative Oncology Group performance status (ECOG PS), primary site (lesions and characteristics), visceral metastases, laboratory data, previous chemotherapy, and multiple bone metastases were analyzed for associations with overall survival (OS). Katagiri scores were calculated for each patient and were used to compare OS. Results: Out of the 616 patients included in this analysis, 574 had died and 42 remained alive. The median follow-up time for survivors was 42 months. Univariate analysis revealed that age (P = 0.604) and multiple bone metastases (P = 0.691) were not significantly associated with OS. Multivariate analysis revealed that sex, ECOG PS, KPS, primary characteristics, visceral metastases, laboratory data, and previous chemotherapy were significantly associated with OS. The survival rates at 3, 6, 12, and 24 months, categorized by Katagiri score, were as follows: score 0–3, 94.4, 77. 8, and 61.1%, respectively; score 4–6, 67.7, 48.7, and 31.2%, respectively; and score 7–10, 39.1, 22.1, and 9.0%, respectively (P < 0.001). Conclusion: Sex, ECOG PS, KPS, primary characteristics, visceral metastases, laboratory data, and previous chemotherapy were significant predictors of survival in patients with bone metastases. The Katagiri scoring system was significantly correlated with OS and can help us select the optimal dose-fractionation. Keywords: Bone metastasis, Prognostic factors, Katagiri scoring system, Palliative radiation therapy, Optimizing dose-fractionation
* Correspondence: [email protected] 1 Department of Radiation Oncology, Hyogo Cancer Center, 13-70, Kita-oji, Akashi, Hyogo, Japan 2 Department of Radiation Oncology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.
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