Journal de biométrie et biostatistique

Parametric Cancer Survival Analysis Based on the Boag Model: A Clinician?s View

Abstract

Shunzo Maetani and John W Gamel

As many cancer patients have recently been cured, it has become necessary in cancer survival analysis to distinguish between cure and delayed death, which make a great difference in survival benefit and quality of life. Also, cancer patients must be provided with relevant and comprehensible information to make optimal decisions. For this purpose, the Boag parametric analysis with a cured fraction has emerged as a relevant model. The authors evaluated this model compared with the Cox model using life-long follow-up data. The parameters of the Boag model provided the comprehensible information patients wish to obtain; particularly, the cure rate served as a useful measure of survival benefit. In contrast, the hazard ratio, a parameter of the Cox model, failed to distinguish cure from delayed death. The Boag model could be extended to regression analysis to evaluate the long-term effects of various factors, including cancer treatment. Also, it could be extended to predict the overall survival

curve and mean survival time using limited follow-up data. In conclusion, the Boag model offered a more relevant measure of the long-term benefit of cancer treatment and other factors than conventional methods, although an ideal model has yet to be developed