Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?

D. Rades, S. Huttenlocher, J. N. Evers, A. Bajrovic, J. H. Karstens, V. Rudat, S. E. Schild

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone.Patients and methods. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45).Results. Improvement of motor function occurred in 21% after S + RT and 24% after RT (p = 0.39). The 1-year local control rates were 81% and 91% (p = 0.44), while the 1-year survival rates were 46% and 39% (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22% after DDSS + RT and 24% after RT alone (p = 0.92). The 1-year local control rates were 95% and 89% (p = 0.62), and the 1-year survival rates were 54% and 43% (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20% after LE + RT and 23% after RT alone (p = 0.06). The 1-year local control rates were 50% and 92% (p = 0.33). The 1-year survival rates were 32% and 32% (p = 0.55).Conclusion. Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival.

Original languageEnglish (US)
Pages (from-to)424-430
Number of pages7
JournalStrahlentherapie und Onkologie
Volume188
Issue number5
DOIs
StatePublished - May 2012

Fingerprint

Spinal Cord Compression
Radiotherapy
Matched-Pair Analysis
Therapeutics
Survival Rate
Laminectomy
Survival
Spine
Research Design

Keywords

  • Elderly patients
  • Metastatic spinal cord compression
  • Radiotherapy
  • Surgery
  • Treatment outcomes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology
  • Medicine(all)

Cite this

Rades, D., Huttenlocher, S., Evers, J. N., Bajrovic, A., Karstens, J. H., Rudat, V., & Schild, S. E. (2012). Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression? Strahlentherapie und Onkologie, 188(5), 424-430. https://doi.org/10.1007/s00066-011-0058-z

Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression? / Rades, D.; Huttenlocher, S.; Evers, J. N.; Bajrovic, A.; Karstens, J. H.; Rudat, V.; Schild, S. E.

In: Strahlentherapie und Onkologie, Vol. 188, No. 5, 05.2012, p. 424-430.

Research output: Contribution to journalArticle

Rades, D, Huttenlocher, S, Evers, JN, Bajrovic, A, Karstens, JH, Rudat, V & Schild, SE 2012, 'Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?', Strahlentherapie und Onkologie, vol. 188, no. 5, pp. 424-430. https://doi.org/10.1007/s00066-011-0058-z
Rades, D. ; Huttenlocher, S. ; Evers, J. N. ; Bajrovic, A. ; Karstens, J. H. ; Rudat, V. ; Schild, S. E. / Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?. In: Strahlentherapie und Onkologie. 2012 ; Vol. 188, No. 5. pp. 424-430.
@article{4be42103f5bb4ace920e0db02c07def9,
title = "Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?",
abstract = "Background. Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone.Patients and methods. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45).Results. Improvement of motor function occurred in 21{\%} after S + RT and 24{\%} after RT (p = 0.39). The 1-year local control rates were 81{\%} and 91{\%} (p = 0.44), while the 1-year survival rates were 46{\%} and 39{\%} (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22{\%} after DDSS + RT and 24{\%} after RT alone (p = 0.92). The 1-year local control rates were 95{\%} and 89{\%} (p = 0.62), and the 1-year survival rates were 54{\%} and 43{\%} (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20{\%} after LE + RT and 23{\%} after RT alone (p = 0.06). The 1-year local control rates were 50{\%} and 92{\%} (p = 0.33). The 1-year survival rates were 32{\%} and 32{\%} (p = 0.55).Conclusion. Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival.",
keywords = "Elderly patients, Metastatic spinal cord compression, Radiotherapy, Surgery, Treatment outcomes",
author = "D. Rades and S. Huttenlocher and Evers, {J. N.} and A. Bajrovic and Karstens, {J. H.} and V. Rudat and Schild, {S. E.}",
year = "2012",
month = "5",
doi = "10.1007/s00066-011-0058-z",
language = "English (US)",
volume = "188",
pages = "424--430",
journal = "Strahlentherapie und Onkologie : Organ der Deutschen R{\"o}ntgengesellschaft ... [et al]",
issn = "0179-7158",
publisher = "Urban und Vogel",
number = "5",

}

TY - JOUR

T1 - Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?

AU - Rades, D.

AU - Huttenlocher, S.

AU - Evers, J. N.

AU - Bajrovic, A.

AU - Karstens, J. H.

AU - Rudat, V.

AU - Schild, S. E.

PY - 2012/5

Y1 - 2012/5

N2 - Background. Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone.Patients and methods. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45).Results. Improvement of motor function occurred in 21% after S + RT and 24% after RT (p = 0.39). The 1-year local control rates were 81% and 91% (p = 0.44), while the 1-year survival rates were 46% and 39% (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22% after DDSS + RT and 24% after RT alone (p = 0.92). The 1-year local control rates were 95% and 89% (p = 0.62), and the 1-year survival rates were 54% and 43% (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20% after LE + RT and 23% after RT alone (p = 0.06). The 1-year local control rates were 50% and 92% (p = 0.33). The 1-year survival rates were 32% and 32% (p = 0.55).Conclusion. Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival.

AB - Background. Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone.Patients and methods. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45).Results. Improvement of motor function occurred in 21% after S + RT and 24% after RT (p = 0.39). The 1-year local control rates were 81% and 91% (p = 0.44), while the 1-year survival rates were 46% and 39% (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22% after DDSS + RT and 24% after RT alone (p = 0.92). The 1-year local control rates were 95% and 89% (p = 0.62), and the 1-year survival rates were 54% and 43% (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20% after LE + RT and 23% after RT alone (p = 0.06). The 1-year local control rates were 50% and 92% (p = 0.33). The 1-year survival rates were 32% and 32% (p = 0.55).Conclusion. Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival.

KW - Elderly patients

KW - Metastatic spinal cord compression

KW - Radiotherapy

KW - Surgery

KW - Treatment outcomes

UR - http://www.scopus.com/inward/record.url?scp=84862705750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862705750&partnerID=8YFLogxK

U2 - 10.1007/s00066-011-0058-z

DO - 10.1007/s00066-011-0058-z

M3 - Article

VL - 188

SP - 424

EP - 430

JO - Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]

JF - Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]

SN - 0179-7158

IS - 5

ER -