Prognostic Index for Liver Radiation (PILiR).

Area of Science:

• Oncology
• Radiotherapy
• Medical Informatics

Background:

• Stereotactic body radiation therapy (SBRT) is used for liver tumors.
• Patient selection for SBRT is crucial, especially for those ineligible for other treatments.
• Predictive tools are needed to optimize outcomes and resource allocation.

Purpose of the Study:

• To develop and validate a prognostic index (PILiR) for predicting survival in patients undergoing liver SBRT.
• To identify key clinical factors associated with early mortality in this patient cohort.
• To improve patient selection for liver-directed radiotherapy.

Main Methods:

• Retrospective analysis of a single-center database of 195 patients treated with liver SBRT.
• Multivariable analysis to identify predictors of early death.
• Development of the Prognostic Index for Liver Radiation (PILiR) based on significant predictors.
• Validation of the index using Area Under the Curve (AUC) for different datasets.

Main Results:

• Child-Pugh Score, serum albumin, and extrahepatic disease were significant predictors of early death in the combined cohort.
• The PILiR score (0-5) demonstrated distinct median survival times: 23.8 months (0 points) to 2.6 months (4-5 points).
• AUC values were 0.78 (combined), 0.84 (HCC), and 0.80 (metastatic), indicating good predictive accuracy.

Conclusions:

• The PILiR is a validated tool for predicting survival in patients undergoing liver SBRT.
• Liver function (Child-Pugh Score, albumin) and extrahepatic disease are critical factors influencing survival.
• PILiR provides valuable prognostic information for patients and caregivers, aiding treatment decisions.