1x8 Gy versus 5x4 Gy for metastatic epidural spinal cord compression: A matched-pair study of three prognostic patient subgroups

Dirk Rades, Antonio J. Conde-Moreno, Jon Cacicedo, Theo Veninga, Barbara Segedin, Karmen Stanic, Volker Rudat, Steven E. Schild

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: This study provides separate comparisons of 1×8Gy to 5×4Gy for metastatic epidural spinal cord compression (MESCC) in patients with poor, intermediate and favorable survival prognoses. Methods: Patients receiving 1×8Gy were matched to patients receiving 5×4Gy for age, gender, performance status, tumor type, involved vertebrae, other bone metastases, visceral metastases, interval between tumor diagnosis and MESCC, ambulatory status and time developing motor deficits. From a study including patients with poor (N=156) or intermediate (N=86) survival prognoses, subgroup analyses were performed. Furthermore, 232 new patients with favorable prognoses matched the same way were included. Results: In poor prognoses patients, 6-month survival rates were 10% after 1×8Gy and 6% after 5×4Gy (p=0.38); in-field reRT rates in few patients alive at 6months were 15 and 2% (p=0.16). In intermediate prognoses patients, 6-month survival rates were 49% after 1×8Gy and 58% after 5×4Gy (p=0.30). ReRT rates at 6months were 23 and 13% (p=0.25). In favorable prognoses patients, 6-month survival rates were 89% after 1×8Gy and 91% after 5×4 Gy. ReRT rates at 6months were 14 and 3% (p=0.007). In no subgroup, RT regimen had a significant impact on motor function. Conclusions: Since in patients with poor prognoses, outcomes after 1×8Gy and 5×4Gy were not significantly different, 1×8Gy may be an option. In patients with intermediate prognoses, a trend was found in favor of 5×4 Gy. In patients with favorable prognoses, need for in-field reRT was greater after 1×8 Gy.

Original languageEnglish (US)
Article number21
JournalRadiation Oncology
Volume13
Issue number1
DOIs
StatePublished - Feb 8 2018

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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    Rades, D., Conde-Moreno, A. J., Cacicedo, J., Veninga, T., Segedin, B., Stanic, K., Rudat, V., & Schild, S. E. (2018). 1x8 Gy versus 5x4 Gy for metastatic epidural spinal cord compression: A matched-pair study of three prognostic patient subgroups. Radiation Oncology, 13(1), [21]. https://doi.org/10.1186/s13014-018-0968-3