RESUMO
BACKGROUND AND PURPOSE: Low-and-middle-income countries have resource constraints and waiting lists for radiotherapy (RT). In this context, we sought to determine the survival of inpatients evaluated for palliative RT in a large referral cancer center in Brazil. MATERIAL AND METHODS: From November 2014 through December 2015, we enrolled 333 inpatients with palliative RT evaluation requests in this prospective observational study. We applied Palliative Prognostic Index (PPI) and Survival Prediction Score using Number of Risk Factors (NRF). Primary endpoint was overall survival. Secondary endpoints were survival by PPI and NRF. (ClinicalTrials.gov number, NCT02312791). RESULTS: Median survival (MS) for the entire cohort was 73â¯days. PPI ≤2 had MS of 120â¯days; PPI 2.5-4 had MS of 55â¯days (HR 1.84; 95% CI, 1.07-3.16); PPI >4 had MS of 39â¯days (HR 3.45; 95% CI, 2.07-5.74) (pâ¯<â¯.0001). NRF 0-1 had MS of 129â¯days; NRF 2 had MS of 73â¯days (HR 1.74; 95% CI 0.89-3.38); NRF 3 had MS of 40â¯days (HR 2.95; 95% CI, 1.50-5.78) (pâ¯<â¯.0001). CONCLUSION: Inpatients with palliative RT requests seem to have an overall poor survival. PPI and NRF can define subgroups with different prognosis. This could help hospitals and healthcare systems to standardize criteria for prioritization and contribute for fairness.
