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

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.

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

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Spinal Cord Compression
Survival Rate
Neoplasm Metastasis
Survival
Neoplasms
Spine

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Rades, D., Conde-Moreno, A. J., Cacicedo, J., Veninga, T., Segedin, B., Stanic, K., ... 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

1x8 Gy versus 5x4 Gy for metastatic epidural spinal cord compression : A matched-pair study of three prognostic patient subgroups. / Rades, Dirk; Conde-Moreno, Antonio J.; Cacicedo, Jon; Veninga, Theo; Segedin, Barbara; Stanic, Karmen; Rudat, Volker; Schild, Steven E.

In: Radiation Oncology, Vol. 13, No. 1, 21, 08.02.2018.

Research output: Contribution to journalArticle

Rades, D, Conde-Moreno, AJ, Cacicedo, J, Veninga, T, Segedin, B, Stanic, K, Rudat, V & Schild, SE 2018, '1x8 Gy versus 5x4 Gy for metastatic epidural spinal cord compression: A matched-pair study of three prognostic patient subgroups' Radiation Oncology, vol. 13, no. 1, 21. https://doi.org/10.1186/s13014-018-0968-3
Rades, Dirk ; Conde-Moreno, Antonio J. ; Cacicedo, Jon ; Veninga, Theo ; Segedin, Barbara ; Stanic, Karmen ; Rudat, Volker ; Schild, Steven E. / 1x8 Gy versus 5x4 Gy for metastatic epidural spinal cord compression : A matched-pair study of three prognostic patient subgroups. In: Radiation Oncology. 2018 ; Vol. 13, No. 1.
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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.",
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T1 - 1x8 Gy versus 5x4 Gy for metastatic epidural spinal cord compression

T2 - Radiation Oncology

AU - Rades, Dirk

AU - Conde-Moreno, Antonio J.

AU - Cacicedo, Jon

AU - Veninga, Theo

AU - Segedin, Barbara

AU - Stanic, Karmen

AU - Rudat, Volker

AU - Schild, Steven E.

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N2 - 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.

AB - 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.

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