Development and external validation of prognostic model for 2-year survival of non-small-cell lung cancer patients treated with chemoradiotherapy

Cary Dehing-Oberije*, Shipeng Yu, Dirk De Ruysscher, Sabine Meersschout, Karen Van Beek, Yolande Lievens, Jan Van Meerbeeck, Wilfried De Neve, Bharat Rao, Hiska van der Weide, Philippe Lambin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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PURPOSE: Radiotherapy, combined with chemotherapy, is the treatment of choice for a large group of non-small-cell lung cancer (NSCLC) patients. Recent developments in the treatment of these patients have led to improved survival. However, the clinical TNM stage is highly inaccurate for the prediction of survival, and alternatives are lacking. The objective of this study was to develop and validate a prediction model for survival of NSCLC patients, treated with chemoradiotherapy.

PATIENTS AND METHODS: The clinical data from 377 consecutive inoperable NSCLC patients, Stage I-IIIB, treated radically with chemoradiotherapy were collected. A prognostic model for 2-year survival was developed, using 2-norm support vector machines. The performance of the model was expressed as the area under the curve of the receiver operating characteristic and assessed using leave-one-out cross-validation, as well as two external data sets.

RESULTS: The final multivariate model consisted of gender, World Health Organization performance status, forced expiratory volume in 1 s, number of positive lymph node stations, and gross tumor volume. The area under the curve, assessed by leave-one-out cross-validation, was 0.74, and application of the model to the external data sets yielded an area under the curve of 0.75 and 0.76. A high- and low-risk group could be clearly identified using a risk score based on the model.

CONCLUSION: The multivariate model performed very well and was able to accurately predict the 2-year survival of NSCLC patients treated with chemoradiotherapy. The model could support clinicians in the treatment decision-making process.

Original languageEnglish
Pages (from-to)355-362
Number of pages8
JournalInternational Journal of Radiation Oncology, Biology, Physics
Issue number2
Publication statusPublished - 1-Jun-2009
Externally publishedYes


  • Aged
  • Analysis of Variance
  • Carcinoma, Non-Small-Cell Lung/drug therapy
  • Cohort Studies
  • Combined Modality Therapy/methods
  • Female
  • Fluorodeoxyglucose F18
  • Forced Expiratory Volume
  • Humans
  • Lung Neoplasms/drug therapy
  • Lymphatic Metastasis
  • Male
  • Models, Statistical
  • Nomograms
  • Positron-Emission Tomography
  • Prognosis
  • Radiopharmaceuticals
  • Radiotherapy Dosage
  • Severity of Illness Index
  • Sex Factors
  • Survival Analysis
  • Survival Rate
  • Tumor Burden

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