Van der Velden et al reported a simple score for identifying a patient likely to respond to radiation therapy for painful bone metastases. The authors are from University Medical Center Utrecht and University of Toronto.
Pain response - one or both of the following:
(1) >= 2 point decrease on 10 cm VAS scale from baseline without increase in analgesics
(2) analgesic decrease >= 25% without increase in pain level
Parameters:
(1) primary tumor site
(2) Karnofsky Performance Status
(3) baseline pain score from 0 to 10
Parameter
Finding
Points
primary site
breast
0
prostate
0
lung
7
other
8
KPS
80 to 100
0
50 to 70
6
20 to 40
12
pain at baseline
0.7 * (score)
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 27
• The higher the score the lower the chances of a pain response.
Score
Observed Response
< 6
80%
6 to 9
68%
10 to 13
57%
14 to 18
44%
>= 19
38%
Performance:
• The area under the ROC curve is 0.63.
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