Do Bladder Cancer Patients with Metastatic Spinal Cord Compression Benefit from Radiotherapy Alone?

Dirk Rades, Jochen Walz, Steven E. Schild, Theo Veninga, Juergen Dunst

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: To investigate the role of radiotherapy (RT) alone in metastatic spinal cord compression (MSCC) patients with bladder cancer. Methods: Thirty-two MSSC patients with bladder cancer were included in this retrospective review. Potential prognostic factors were investigated for functional outcome, local control of MSCC, and survival: age, gender, performance status, visceral metastases at the time of RT, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT, and radiation schedule (short-course RT [1 week or less] versus long-course RT [2 to 4 weeks]). Results: Two patients (6%) showed improvement of motor function, 25 (78%) no change, and 5 (16%) deterioration. Better functional outcome was significantly associated with a better performance status (P = 0.035). A trend was observed for absence of visceral metastases (P = 0.054). Five patients developed a recurrence of MSCC in the preirradiated spinal region, which was treated with reirradiation (0 improvement, 4 no change, 1 deterioration). Median survival was 4 months. The 1-year survival rate was only 16%. Better survival was associated with absence of visceral metastases, being ambulatory, involvement of only one to three vertebrae, and better performance status. Conclusions: Improvement of motor function was rare. For patients not suitable for decompressive surgery, short-course RT seems preferable because it provides a functional outcome similar to that with long-course RT and is more patient convenient. If the patient's prognosis seems extremely poor in terms of functional outcome and survival, single-fraction RT or even best supportive care may be considered.

Original languageEnglish (US)
Pages (from-to)1081-1085
Number of pages5
JournalUrology
Volume69
Issue number6
DOIs
StatePublished - Jun 2007

Fingerprint

Spinal Cord Compression
Urinary Bladder Neoplasms
Radiotherapy
Survival
Neoplasm Metastasis
Spine
Appointments and Schedules
Survival Rate
Radiation
Recurrence

ASJC Scopus subject areas

  • Urology

Cite this

Do Bladder Cancer Patients with Metastatic Spinal Cord Compression Benefit from Radiotherapy Alone? / Rades, Dirk; Walz, Jochen; Schild, Steven E.; Veninga, Theo; Dunst, Juergen.

In: Urology, Vol. 69, No. 6, 06.2007, p. 1081-1085.

Research output: Contribution to journalArticle

Rades, Dirk ; Walz, Jochen ; Schild, Steven E. ; Veninga, Theo ; Dunst, Juergen. / Do Bladder Cancer Patients with Metastatic Spinal Cord Compression Benefit from Radiotherapy Alone?. In: Urology. 2007 ; Vol. 69, No. 6. pp. 1081-1085.
@article{9039b2e48a4c4f55a73a5fb08dbbae86,
title = "Do Bladder Cancer Patients with Metastatic Spinal Cord Compression Benefit from Radiotherapy Alone?",
abstract = "Objectives: To investigate the role of radiotherapy (RT) alone in metastatic spinal cord compression (MSCC) patients with bladder cancer. Methods: Thirty-two MSSC patients with bladder cancer were included in this retrospective review. Potential prognostic factors were investigated for functional outcome, local control of MSCC, and survival: age, gender, performance status, visceral metastases at the time of RT, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT, and radiation schedule (short-course RT [1 week or less] versus long-course RT [2 to 4 weeks]). Results: Two patients (6{\%}) showed improvement of motor function, 25 (78{\%}) no change, and 5 (16{\%}) deterioration. Better functional outcome was significantly associated with a better performance status (P = 0.035). A trend was observed for absence of visceral metastases (P = 0.054). Five patients developed a recurrence of MSCC in the preirradiated spinal region, which was treated with reirradiation (0 improvement, 4 no change, 1 deterioration). Median survival was 4 months. The 1-year survival rate was only 16{\%}. Better survival was associated with absence of visceral metastases, being ambulatory, involvement of only one to three vertebrae, and better performance status. Conclusions: Improvement of motor function was rare. For patients not suitable for decompressive surgery, short-course RT seems preferable because it provides a functional outcome similar to that with long-course RT and is more patient convenient. If the patient's prognosis seems extremely poor in terms of functional outcome and survival, single-fraction RT or even best supportive care may be considered.",
author = "Dirk Rades and Jochen Walz and Schild, {Steven E.} and Theo Veninga and Juergen Dunst",
year = "2007",
month = "6",
doi = "10.1016/j.urology.2007.02.045",
language = "English (US)",
volume = "69",
pages = "1081--1085",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Do Bladder Cancer Patients with Metastatic Spinal Cord Compression Benefit from Radiotherapy Alone?

AU - Rades, Dirk

AU - Walz, Jochen

AU - Schild, Steven E.

AU - Veninga, Theo

AU - Dunst, Juergen

PY - 2007/6

Y1 - 2007/6

N2 - Objectives: To investigate the role of radiotherapy (RT) alone in metastatic spinal cord compression (MSCC) patients with bladder cancer. Methods: Thirty-two MSSC patients with bladder cancer were included in this retrospective review. Potential prognostic factors were investigated for functional outcome, local control of MSCC, and survival: age, gender, performance status, visceral metastases at the time of RT, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT, and radiation schedule (short-course RT [1 week or less] versus long-course RT [2 to 4 weeks]). Results: Two patients (6%) showed improvement of motor function, 25 (78%) no change, and 5 (16%) deterioration. Better functional outcome was significantly associated with a better performance status (P = 0.035). A trend was observed for absence of visceral metastases (P = 0.054). Five patients developed a recurrence of MSCC in the preirradiated spinal region, which was treated with reirradiation (0 improvement, 4 no change, 1 deterioration). Median survival was 4 months. The 1-year survival rate was only 16%. Better survival was associated with absence of visceral metastases, being ambulatory, involvement of only one to three vertebrae, and better performance status. Conclusions: Improvement of motor function was rare. For patients not suitable for decompressive surgery, short-course RT seems preferable because it provides a functional outcome similar to that with long-course RT and is more patient convenient. If the patient's prognosis seems extremely poor in terms of functional outcome and survival, single-fraction RT or even best supportive care may be considered.

AB - Objectives: To investigate the role of radiotherapy (RT) alone in metastatic spinal cord compression (MSCC) patients with bladder cancer. Methods: Thirty-two MSSC patients with bladder cancer were included in this retrospective review. Potential prognostic factors were investigated for functional outcome, local control of MSCC, and survival: age, gender, performance status, visceral metastases at the time of RT, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT, and radiation schedule (short-course RT [1 week or less] versus long-course RT [2 to 4 weeks]). Results: Two patients (6%) showed improvement of motor function, 25 (78%) no change, and 5 (16%) deterioration. Better functional outcome was significantly associated with a better performance status (P = 0.035). A trend was observed for absence of visceral metastases (P = 0.054). Five patients developed a recurrence of MSCC in the preirradiated spinal region, which was treated with reirradiation (0 improvement, 4 no change, 1 deterioration). Median survival was 4 months. The 1-year survival rate was only 16%. Better survival was associated with absence of visceral metastases, being ambulatory, involvement of only one to three vertebrae, and better performance status. Conclusions: Improvement of motor function was rare. For patients not suitable for decompressive surgery, short-course RT seems preferable because it provides a functional outcome similar to that with long-course RT and is more patient convenient. If the patient's prognosis seems extremely poor in terms of functional outcome and survival, single-fraction RT or even best supportive care may be considered.

UR - http://www.scopus.com/inward/record.url?scp=34249986674&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249986674&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2007.02.045

DO - 10.1016/j.urology.2007.02.045

M3 - Article

C2 - 17572191

AN - SCOPUS:34249986674

VL - 69

SP - 1081

EP - 1085

JO - Urology

JF - Urology

SN - 0090-4295

IS - 6

ER -