Survival Prediction Model for Palliative Bone Metastasis Radiotherapy

This tool can be used at the time of consultation for palliative radiotherapy of bone metastasis to estimate survival time from consultation until death based on patient-specific values for 26 prognostic variables. Patients and providers can use this information to guide decision-making for radiotherapy, chemotherapy, and surgical interventions in patients with cancer metastatic to the bone.

Please answer the following questions reflecting patient status at the time of consultation. Entries with symbols are required fields. For non-required fields, leave values blank if the value is unknown, indeterminate, or not applicable.

Age (yrs):

White blood cell count within 1 month of consultation: in µL (reference range 4500-1100)

Lymphocytes count within 1 month of consultation: in µL (reference range 1100-4800)

Time since initial primary cancer diagnosis : in weeks
Diagnosis is defined as time of initial pathologic confirmation of cancer; if not applicable, use the earlier available time since confirmatory imaging, labs, or physical exam findings. Please subtract this date from the date of consultation.

Gender:
Male Female

Race:
White African American Asian Other

Primary cancer site:
Breast Prostate Leukemias Lung Other

Karnosfky Performance Status:
100 90 80 70 60 50 40 30 20 10 0

Site of current palliative radiotherapy:
If overlapping sites, select the site that encompasses the majority of disease.
Spine Extremity Hip/Pelvis Chest wall Skull

If site of current radiotherapy is the spine, is there radiologic evidence of nerve root, spinal canal, or spinal cord involvement?
Yes No

Was there prior surgery at the current site of palliative radiotherapy?
Yes No

Are there other sites of metastatic disease that are going to be treated concurrently (in non-contiguous fields)?
If multiple fields are in direct approximation in order to cover a large area of involvement, select no.
Yes No

Is the patient admitted at the hospital (inpatient)?
For patients admitted at offsite rehabilitation hospitals, hospice, and nursing facilities, select no.
Yes No

Is the patient currently taking steroid medication?
Yes No

Is the patient currently taking opioid pain medication?
Yes No

Did the patient receive chemotherapy in the prior 1 month?
Yes No

If so, what was the most recent chemotherapy type?
If a patient is on multiple types of chemotherapy, please select a single response using the following order: IV > Oral > Hormonal.
IV Oral Hormonal

Does the patient report any weight loss within the past 6 months?
Yes No

Please select all radiologically-confirmed sites of metastases other than the current site of palliative radiation.
Include all other metastatic lesions that will not be contained current palliative radiation field. Leave the box empty for unknown or indeterminate involvement of a given site. Locoregional lymph nodes from the primary cancer may be included.
Brain Lung Liver Adrenal glands
Lymph nodes Soft tissue Other bone Other sites not specified

Based on entries from 26 prognostic variables, the patient-specific survival curve will be displayed below. This plot was generated using random survival forest methodology for a cohort of 397 patients treated at Johns Hopkins Hospital from 1/2007 through 1/2013 and has been internally validated for this population. THIS MODEL HAS NOT UNDERGONE EXTERNAL VALIDATION. PLEASE INTERPRET RESULTS WITH EXTREME CAUTION WHEN APPLYING THESE DATA TO OUTSIDE PATIENT POPULATIONS. Although our method is generally robust against the effects of missing data, additional caution should be used when interpreting results in the setting of increasing number of missing or unknown values. Results should be used in combination with other relevant details of the patient history, diagnostic studies, and physical exam. This tool does not replace the need for clinical judgment and consideration of patient preference when used to assist in the decision-making process.

I understand these limitations and agree to proceed
I do not agree to proceed

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Copyright © 2007 The Johns Hopkins University Department of Radiation Oncology