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Survival prediction models
F. Arbabi M.D Radiation Oncologist
§Divination
• What happened in next IAEA and IRAN negotiations?
• How much I will have in next 10 years?
• Is the rate of inflation decreased?
• Will she marry me?
Survival Questions…?
This lazy brain!
• Disease Free Survival
• Progression Free Survival
• Response Rate
• Clinical Benefit
End points …
SURVIVAL
Prognostic factors
Learning from history
Regression models
demographic and clinical covariates are combined in a Cox model with staging information from the American Joint Committee on Cancer (AJCC) staging system to predict a patient’s survival to improve treatment recommendations
Recursive Partitioning Analysis
Recursive Partitioning Analysis
Demographic
Disease
Treatment
?
Recursive Partitioning AnalysisDefine distinct subgroups based on survival
RPA of prognostic factors in three RTOG malignant glioma trials.
1578 patients from 3 trialsDefine 6 groupsFrom 32 to 256 in each groupMedian survival from 4.7 months to 58.6
J Natl Cancer Inst. 1993 May 5;85(9):704-10
Prognostic factorsAge
Performance status
GradeExtent of surgery
Radiation dose
Mini mental status exam
Demographic
Disease
TreatmentTemozolomide
?
?
J Neurooncol. Aug 2011; 104(1): 339–349.
Demographic
Disease
TreatmentTemozolomide
Genetics
?
• MGMT
• IDH 1, IDH2
• pAKT, c-met
• mRNA profiling
Demographic
Disease
Treatment
Temozolomide
Genetics
Radiology
?