An easy tool to predict survival in patients with bone metastatic lung cancer treated with palliative radiotherapy

Abstract

Abstract Background This study aimed to devise a simple assessment system for bone metastases (BMs) from lung cancer (LC). Methods A total of 368 LC patients with BMs who underwent radiotherapy (RT) were retrospectively reviewed. Prognostic factors were evaluated using multivariate analysis, and a scoring system based on regression coefficients was devised. Results The median follow‐up time for survival was 4.3 months, and the 0.5‐year overall survival (OS) rate was 44.7%. In the multivariate analysis, the significant prognostic factors were performance status (PS), metastases to internal organs, and post‐RT molecular‐targeting therapies (MTs) (tyrosine kinase inhibitors, and/or immune checkpoint inhibitors). A scoring system aggregating points assigned to each risk factor was created (2 points; non‐administration of post‐RT MTs, 1 point; PS ≥3 and metastases to internal organs). The median OSs were 25.0 months, 12.8 months, and 2.5 months in patients with a total score of 0 (n = 22), 1–2 (n = 124), and 3–4 (n = 221), respectively (p < 0.01). Conclusion This easy‐to‐use scoring system is useful for selecting patients who received comparatively high‐dose fractionated RT for BMs from LC. Updates are required to follow the progress of systemic therapy.

Keywords

• bone metastasis
• individualized therapy
• lung cancer
• palliative radiotherapy
• prognostic factor