ArticleCancer medicine2021
Association of radiation dose intensity with overall survival in patients with distant metastases.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Incremental Value of Radiation Dose for Prognostic Stratification Beyond Performance Status in Palliative Radiation Therapy for Bone Metastases.Advances in radiation oncology · 2026Article
- Explainable Deep Learning Model for Predicting Overall Survival in Patients Receiving Palliative Radiotherapy for Bone Metastases.Current oncology (Toronto, Ont.) · 2026Article
- Long-term survival and undetectable circulating tumor DNA following comprehensive involved site radiotherapy for oligometastases.Scientific reports · 2025Article
- Predicting long‑term survival following involved site radiotherapy for oligometastases.Oncology letters · 2024Article
- Dosimetric comparison of four radiotherapy techniques for stage III non‑small cell lung cancer.Oncology letters · 2023Article
- Association of radiation dose intensity with overall survival in patients with distant metastases.Cancer medicine · 2021Article
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with metastatic cancer referred to radiation oncology have diverse prognoses and there is significant interest in personalizing treatment. We hypothesized that patients selected for higher biologically equivalent doses have improved overall survival.
methodsThe study population consists of 355 consecutive adult patients with distant metastases treated by a single radiation oncologist from 2014 to 2018. The validated NEAT model was used to prospectively stratify patients into four distinct cohorts. Radiation dose intensity was standardized using the equivalent dose in 2 Gy fractions (EQD2) model with an α/β of 10. Radiation dose intensity on survival was assessed via Cox regression models and propensity score match pairing with Kaplan-Meier analysis.
resultsThe median survival was 9.3 months and the median follow-up for surviving patients was 18.3 months. The NEAT model cohorts indicated median survivals of 29.5, 11.8, 4.9, and 1.8 months. Patients receiving an EQD2 of ≥40 Gy had a median survival of 16.0 months versus 3.8 months for patients receiving an EQD2 of <40 Gy (p < 0.001). On multivariable analysis, performance status, primary tumor site, radiation dose intensity, albumin, liver metastases, and number of active tumors were all independent predictors of survival (p < 0.05 for all). Propensity score matching was performed for performance status, albumin, number of active tumors, primary tumor site, and liver metastasis, finding higher EQD2 to remain significantly associated with improved survival within the matched cohort (p = 0.004).
conclusionHigher radiation dose intensity was used in patients with better prognosis and was associated with improved survival for patients with metastatic disease.
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