Krishnan et al reported the TEACHH model for predicting life expectancy of a patient with metastatic cancer who is being evaluated for palliative radiotherapy. This can help the patient make decisions about palliative care. The authors are from Dana Farber Cancer Institute, Harvard Medical School and Massachusetts General Hospital.
Patient selection: metastatic cancer, being evaluated for palliative radiotherapy
TEACHH is an acronym for the parameters identified.
Parameters:
(1) type of cancer (T)
(2) ECOG performance status (E)
(3) age in yearsyears (A)
(4)prior palliative chemotherapy courses (C)
(5) hepatic metastases (H)
(6) hospitalizations in the 3 months prior to palliative radiotherapy (H)
|
Parameter
|
Findings
|
Risk Factor
|
Partial Score
|
|
type of cancer
|
breast or prostate
|
0
|
0
|
|
|
lung
|
1
|
5
|
|
|
other
|
1
|
2
|
|
ECOG
|
0 or 1
|
0
|
0
|
|
|
2
|
1
|
4
|
|
|
3 or 4
|
1
|
6
|
|
age
|
<= 60 years
|
0
|
0
|
|
|
> 60 years
|
1
|
2
|
|
chemotherapy
|
0 or 1
|
0
|
0
|
|
|
>=2
|
1
|
3
|
|
hepatic metastases
|
no
|
0
|
0
|
|
|
yes
|
1
|
4
|
|
hospitalizations
|
0
|
0
|
0
|
|
|
>=1
|
1
|
2
|
number of risk factors =
= SUM(number of predictors present)
partial score =
= SUM(points for partial score)
Interpretation:
• minimum number of risk factors present: 0
• maximum number of risk factors present: 6
• minimum partial score: 0
• maximum partial score: 22
|
Number of Risk Factors
|
Group
|
Median OS in Months
|
|
0 or 1
|
A
|
19.9
|
|
2 to 4
|
B
|
5
|
|
5 or 6
|
C
|
1.7
|
|
Partial Score
|
Group
|
Median OS in Months
|
|
0 or 4
|
A
|
17.5
|
|
5 to 15
|
B
|
4.8
|
|
>= 16
|
C
|
1.6
|
Performance:
• The area under the ROC curve is 0.59.
