(1) Background: Prognostication in patients with cancer receiving palliative radiotherapy remains a challenge. To improve the process, we aim to identify prognostic factors in this population from the literature and offer evidence-based recommendations on prognostication in patients undergoing palliative radiotherapy for non-curable or advanced cancers. (2) Methods: A systematic review was performed on the medical literature from 2005 to 2023 to extract papers on the prognosis of palliative radiotherapy patients with advanced cancer. The initial selection was performed by at least two authors to determine study relevance to the target area. Studies were then classified based on type and evidence quality to determine final recommendations. (3) Results: The literature search returned 57 papers to be evaluated. Clinical and biological prognostic factors were identified from these papers to improve clinical decision making or construct prognostic models. Twenty prognostic models were identified for clinical use. There is moderate evidence supporting (i) evidence-based factors (patient, clinical, disease, and lab) in guiding decision making around palliative radiation; (ii) that certain biological factors are of importance; (iii) prognostication models in patients with advanced cancer; and that (iv) SBRT or re-irradiation use can be guided by predictions of survival by prognostic scores or clinicians. Patients with more favorable prognoses are generally better suited to SBRT or re-irradiation, and the use of prognostic models can aid in this decision making. (4) Conclusions: This evaluation has identified several factors or tools to aid in prognosis and clinical decision making. Future studies should aim to further validate these tools and factors in a clinical setting, including the leveraging of electronic medical records for data availability. To increase our understanding of how causal factors interact with palliative radiotherapy, future studies should also examine and include prediction of response to radiation as an outcome.
(1) 背景：接受姑息性放疗的癌症患者预后评估仍具挑战性。为优化评估流程，本研究旨在通过文献梳理明确该人群的预后影响因素，并就不可治愈或晚期癌症患者接受姑息放疗的预后评估提供循证建议。(2) 方法：对2005年至2023年医学文献进行系统综述，筛选关于晚期癌症姑息放疗患者预后的研究文献。由至少两名研究者完成初步筛选，评估文献与目标领域的相关性。根据研究类型和证据质量对文献进行分类，最终形成推荐意见。(3) 结果：文献检索共纳入57篇待评估文献。从中识别出可改善临床决策或构建预后模型的临床与生物学预后因素，共发现20个可供临床使用的预后模型。现有证据中等程度支持以下结论：(i) 循证因素（患者特征、临床表现、疾病状态及实验室指标）可指导姑息放疗决策；(ii) 特定生物学因素具有重要预后价值；(iii) 晚期癌症患者预后模型具有临床适用性；(iv) 立体定向放疗或再程放疗的实施可依据预后评分或临床医师的生存预测进行决策。预后较佳的患者通常更适合接受立体定向放疗或再程放疗，预后模型的应用有助于此类临床决策。(4) 结论：本研究明确了若干有助于预后评估和临床决策的影响因素及工具。未来研究应致力于在临床环境中进一步验证这些工具和因素，包括利用电子病历系统提升数据可及性。为深入理解因果因素与姑息放疗的交互机制，后续研究还应将放疗反应性预测作为结局指标纳入考察范围。
肿瘤(癌症)患者之家