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

?