Park H. Validation of the prognostic model for palliative radiotherapy in older patients with cancer. World J Clin Oncol 2025; 16(3): 101705 [DOI: 10.5306/wjco.v16.i3.101705]
Corresponding Author of This Article
Hyojung Park, Doctor, MD, Associate Professor, Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan 46115, South Korea. hj0714.park@dkuh.co.kr
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Mar 24, 2025; 16(3): 101705 Published online Mar 24, 2025. doi: 10.5306/wjco.v16.i3.101705
Validation of the prognostic model for palliative radiotherapy in older patients with cancer
Hyojung Park
Hyojung Park, Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 46115, South Korea
Author contributions: Park H collected the patients’ clinical data and wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Dankook University Hospital Institutional Review Board (Approval No. DKUH 2024-09-006).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declared that we have no financial and personal relationship with other people or organizations that can inappropriately influence our work.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyojung Park, Doctor, MD, Associate Professor, Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan 46115, South Korea. hj0714.park@dkuh.co.kr
Received: October 3, 2024 Revised: November 23, 2024 Accepted: January 7, 2025 Published online: March 24, 2025 Processing time: 110 Days and 6.6 Hours
Abstract
BACKGROUND
Older patients are more likely to have a poor performance status and comorbidities. There is a reluctance to extensively investigate and treat older patients. As elderly individuals and patients with neoplasms each increase in number, palliative treatment of older patients is expected to grow as an issue.
AIM
To investigated the role of palliative radiotherapy in older patients and patients who were expected to demonstrate a therapeutic effect.
METHODS
From February 2019 to February 2022, 33 patients aged ≥ 80 years underwent palliative radiotherapy. The prognosis in palliative care study predictor (PiPS), palliative prognostic index (PPI), and delirium-palliative prognostic score (D-PaP) models were used for prognosis prediction. D-PaP scores calculated according to the doctor's prediction of clinical prediction of survival (CPS) were excluded and then analyzed for comparison. Radiation was prescribed at a dose of 2.5-7 Gy per fraction, up to a median of 39 Gy10 (range, 28-75 Gy10).
RESULTS
The median follow-up was 2.4 months (range, 0.2-27.5 months), and 28 patients (84.8%) showed subjective symptom improvements following treatment. The 2- and 6-month survival rates of all patients were 91.5% and 91.5%, respectively. According to regression analysis, the performance status index, symptom type, and radiation dose all showed no significant correlation with the treatment response. When survival was expected for > 55 days in the PiPS model, the 2-month survival rate was 94.4%. For patients with PPI and D-PaP-CPS values of 0-3.9 points, the 2-month survival rates were 90.0% and 100%, respectively. For patients with a score of ≥ 4 points, the 2-month survival rates were 37.5% and 0%, respectively.
CONCLUSION
This study shows that the prognosis prediction model used in palliative care can be used to identify patients suitable for treatment.
Core Tip: This is a retrospective study to investigate the role of palliative radiotherapy in older patients and patients who were expected to demonstrate a great therapeutic effect. The prognosis in palliative care study predictor, palliative prognostic index, and delirium-palliative prognostic score models were used for prognosis prediction. Most of patients showed subjective symptom improvements following treatment. The prognosis prediction model showed good correlation with survival. In order to increase the therapeutic effectiveness in palliative radiotherapy, it is necessary to assess a patient's exact prognosis and select appropriate patients accordingly.
