PT - JOURNAL ARTICLE AU - CARSTEN NIEDER AU - BÅRD MANNSÅKER AU - ROSALBA YOBUTA TI - Independent Validation of a Comprehensive Machine Learning Approach Predicting Survival After Radiotherapy for Bone Metastases AID - 10.21873/anticanres.14905 DP - 2021 Mar 01 TA - Anticancer Research PG - 1471--1474 VI - 41 IP - 3 4099 - http://ar.iiarjournals.org/content/41/3/1471.short 4100 - http://ar.iiarjournals.org/content/41/3/1471.full SO - Anticancer Res2021 Mar 01; 41 AB - Background/Aim: The aim of this study was to analyze the survival predictions obtained from a web platform allowing for computation of the so-called Bone Metastases Ensemble Trees for Survival (BMETS). This prediction model is based on a machine learning approach and considers 27 prognostic covariates. Patients and Methods: This was a retrospective single-institution analysis of 326 patients, managed with palliative radiotherapy for bone metastases. Deviations between model-predicted survival and observed survival were assessed. Results: The median actuarial survival was 7.5 months. In total, 59% of patients survived for a period shorter than predicted. Twenty percent of the predictions of the median survival deviated from the observed survival by at least 6 months. Regarding actual survival <3 months (99 of 326 patients), the BMETS-predicted median survival was <3 months, i.e. correct in 67 of 99 cases (68%), whereas the model predicted a median of 4-6 months in 16 (16%) and of >6 months in another 16 cases. Conclusion: The model predicted survival with high accuracy in a large number of patients. Nevertheless, if the model predicts a low likelihood of 3-month survival, actual survival may be very poor (often 1 month or less). Also, in patients who died within 3 months from the start of radiotherapy, the model often predicted longer survival (16% had >6 months predicted median survival). It would, therefore, be interesting to feed the U.S. database utilized to develop the BMETS with additional poor-prognosis patients to optimize the predictions.