A matched-pair analysis comparing 5x4 Gy and 10x3 Gy for metastatic spinal cord compression (MSCC) in patients with favorable survival prognoses

Dirk Rades, Stefan Huttenlocher, Theo Veninga, Amira Bajrovic, Michael Bremer, Volker Rudat, Steven E. Schild

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: It is currently not possible to get an approval of our ethics committee for a randomized trial cmparing 5x4 Gy and 10x3 Gy for MSCC that includes patients with favorable survival prognoses. Therefore, this matched-pair study following strict matching criteria was perfomed instead. Methods: In this study, 142 receiving 5x4 Gy were retrospectively matched (1:1) to 142 patients receiving 10x3 Gy with respect to ten characteristics. These characteristics included age, gender, performance status, tumor type, involved vertebrae, other bone metastases, visceral metastases, interval between tumor diagnosis and MSCC, pre-RT ambulatory status, and time developing motor deficits. Results: On multivariate analysis, post-RT motor function was associated with performance status (p < 0.001), tumor type (p < 0.001), and time developing motor deficits (p < 0.001). RT was successful in 76% of patients receiving 5x4 Gy and 69% receiving 10x3 Gy (p = 0.14). Pre.RT ambulatory status showed a strong trend with respect to local control (LC) of MSCC in the multivariate analysis (p = 0.058). 1-year LC rates were 87% after 5x4 Gy and 93% after 10x3 Gy (p = 0.16). On multivariate analysis, survival (OS) was associated with performance score (p <0.001), visceral metastases (p < 0.001), and pre-RT ambulatory status (p = 0.004). 1-year OS rates were 68% after 5x4 Gy and 73% after 10x3 Gy (p = 0.64). Conclusions: In patients irradiated for MSCC who had favorable survival prognoses, post-RT motor function, LC and OS were not significantly different after 5x4 Gy and after 10x3 Gy.

Original languageEnglish (US)
Article number90
JournalRadiation Oncology
Volume10
Issue number1
DOIs
StatePublished - Apr 15 2015

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Matched-Pair Analysis
Spinal Cord Compression
Neoplasm Metastasis
Survival
Multivariate Analysis
Neoplasms
Ethics Committees
Spine
Bone and Bones

Keywords

  • Favorable survival prognoses
  • Fractionation schedules
  • Irradiation
  • Metastatic spinal cord compression
  • Treatment outcomes

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

A matched-pair analysis comparing 5x4 Gy and 10x3 Gy for metastatic spinal cord compression (MSCC) in patients with favorable survival prognoses. / Rades, Dirk; Huttenlocher, Stefan; Veninga, Theo; Bajrovic, Amira; Bremer, Michael; Rudat, Volker; Schild, Steven E.

In: Radiation Oncology, Vol. 10, No. 1, 90, 15.04.2015.

Research output: Contribution to journalArticle

Rades, Dirk ; Huttenlocher, Stefan ; Veninga, Theo ; Bajrovic, Amira ; Bremer, Michael ; Rudat, Volker ; Schild, Steven E. / A matched-pair analysis comparing 5x4 Gy and 10x3 Gy for metastatic spinal cord compression (MSCC) in patients with favorable survival prognoses. In: Radiation Oncology. 2015 ; Vol. 10, No. 1.
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abstract = "Background: It is currently not possible to get an approval of our ethics committee for a randomized trial cmparing 5x4 Gy and 10x3 Gy for MSCC that includes patients with favorable survival prognoses. Therefore, this matched-pair study following strict matching criteria was perfomed instead. Methods: In this study, 142 receiving 5x4 Gy were retrospectively matched (1:1) to 142 patients receiving 10x3 Gy with respect to ten characteristics. These characteristics included age, gender, performance status, tumor type, involved vertebrae, other bone metastases, visceral metastases, interval between tumor diagnosis and MSCC, pre-RT ambulatory status, and time developing motor deficits. Results: On multivariate analysis, post-RT motor function was associated with performance status (p < 0.001), tumor type (p < 0.001), and time developing motor deficits (p < 0.001). RT was successful in 76{\%} of patients receiving 5x4 Gy and 69{\%} receiving 10x3 Gy (p = 0.14). Pre.RT ambulatory status showed a strong trend with respect to local control (LC) of MSCC in the multivariate analysis (p = 0.058). 1-year LC rates were 87{\%} after 5x4 Gy and 93{\%} after 10x3 Gy (p = 0.16). On multivariate analysis, survival (OS) was associated with performance score (p <0.001), visceral metastases (p < 0.001), and pre-RT ambulatory status (p = 0.004). 1-year OS rates were 68{\%} after 5x4 Gy and 73{\%} after 10x3 Gy (p = 0.64). Conclusions: In patients irradiated for MSCC who had favorable survival prognoses, post-RT motor function, LC and OS were not significantly different after 5x4 Gy and after 10x3 Gy.",
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AU - Rades, Dirk

AU - Huttenlocher, Stefan

AU - Veninga, Theo

AU - Bajrovic, Amira

AU - Bremer, Michael

AU - Rudat, Volker

AU - Schild, Steven E.

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AB - Background: It is currently not possible to get an approval of our ethics committee for a randomized trial cmparing 5x4 Gy and 10x3 Gy for MSCC that includes patients with favorable survival prognoses. Therefore, this matched-pair study following strict matching criteria was perfomed instead. Methods: In this study, 142 receiving 5x4 Gy were retrospectively matched (1:1) to 142 patients receiving 10x3 Gy with respect to ten characteristics. These characteristics included age, gender, performance status, tumor type, involved vertebrae, other bone metastases, visceral metastases, interval between tumor diagnosis and MSCC, pre-RT ambulatory status, and time developing motor deficits. Results: On multivariate analysis, post-RT motor function was associated with performance status (p < 0.001), tumor type (p < 0.001), and time developing motor deficits (p < 0.001). RT was successful in 76% of patients receiving 5x4 Gy and 69% receiving 10x3 Gy (p = 0.14). Pre.RT ambulatory status showed a strong trend with respect to local control (LC) of MSCC in the multivariate analysis (p = 0.058). 1-year LC rates were 87% after 5x4 Gy and 93% after 10x3 Gy (p = 0.16). On multivariate analysis, survival (OS) was associated with performance score (p <0.001), visceral metastases (p < 0.001), and pre-RT ambulatory status (p = 0.004). 1-year OS rates were 68% after 5x4 Gy and 73% after 10x3 Gy (p = 0.64). Conclusions: In patients irradiated for MSCC who had favorable survival prognoses, post-RT motor function, LC and OS were not significantly different after 5x4 Gy and after 10x3 Gy.

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KW - Metastatic spinal cord compression

KW - Treatment outcomes

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