Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression

Dirk Rades, Fabian Fehlauer, Rainer Schulte, Theo Veninga, Lukas J A Stalpers, Hiba Basic, Amira Bajrovic, Peter J. Hoskin, Silke Tribius, Ingeborg Wildfang, Volker Rudat, Rita Engenhart-Cabilic, Johann H. Karstens, Winfried Alberti, Juergen Dunst, Steven E. Schild

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Abstract

Purpose: To evaluate potential prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression (MSCC). Patients and Methods: The following potential prognostic factors were investigated retrospectively in 1,852 patients irradiated for MSCC: age, sex, performance status, primary tumor, interval between tumor diagnosis and MSCC (≤ 15 v > 15 months), number of involved vertebrae (one to two v ≥ three), other bone metastases, visceral metastases, pretreatment ambulatory status, time of developing motor deficits before radiotherapy (faster, 1 to 14 v slower, > 14 days), and radiation schedule (short-course v long-course radiotherapy). Results: On univariate analysis, improved local control of MSCC was associated significantly with favorable histology (breast cancer, prostate cancer, lymphoma/myeloma), no visceral metastases, and long-course radiotherapy. On multivariate analysis, absence of visceral metastases and radiation schedule maintained significance. On univariate analysis, improved survival was associated significantly with female sex, favorable histology, no visceral or other bone metastases, good performance status, being ambulatory before radiotherapy, longer interval between tumor diagnosis and MSCC, and slower development of motor deficits before radiotherapy. Long-course radiotherapy showed a trend. On multivariate analysis, histology, visceral metastases, other bone metastases, ambulatory status before radiotherapy, interval between tumor diagnosis and MSCC, and time of developing motor deficits maintained significance. Conclusion: Poorer local control after radiotherapy for MSCC is associated with visceral metastases and short-course radiotherapy. Long-course radiotherapy seems preferable for patients with more favorable prognoses, given that these patients may live long enough to develop MSCC recurrences. Long-term survival after radiotherapy for MSCC may be predicted if several prognostic factors are considered.

Original languageEnglish (US)
Pages (from-to)3388-3393
Number of pages6
JournalJournal of Clinical Oncology
Volume24
Issue number21
DOIs
StatePublished - Jul 20 2006
Externally publishedYes

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Spinal Cord Compression
Radiotherapy
Survival
Neoplasm Metastasis
Histology
Bone and Bones
Neoplasms
Prostatic Neoplasms
Appointments and Schedules
Multivariate Analysis
Radiation
Lymphoma
Spine

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Rades, D., Fehlauer, F., Schulte, R., Veninga, T., Stalpers, L. J. A., Basic, H., ... Schild, S. E. (2006). Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. Journal of Clinical Oncology, 24(21), 3388-3393. https://doi.org/10.1200/JCO.2005.05.0542

Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. / Rades, Dirk; Fehlauer, Fabian; Schulte, Rainer; Veninga, Theo; Stalpers, Lukas J A; Basic, Hiba; Bajrovic, Amira; Hoskin, Peter J.; Tribius, Silke; Wildfang, Ingeborg; Rudat, Volker; Engenhart-Cabilic, Rita; Karstens, Johann H.; Alberti, Winfried; Dunst, Juergen; Schild, Steven E.

In: Journal of Clinical Oncology, Vol. 24, No. 21, 20.07.2006, p. 3388-3393.

Research output: Contribution to journalArticle

Rades, D, Fehlauer, F, Schulte, R, Veninga, T, Stalpers, LJA, Basic, H, Bajrovic, A, Hoskin, PJ, Tribius, S, Wildfang, I, Rudat, V, Engenhart-Cabilic, R, Karstens, JH, Alberti, W, Dunst, J & Schild, SE 2006, 'Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression', Journal of Clinical Oncology, vol. 24, no. 21, pp. 3388-3393. https://doi.org/10.1200/JCO.2005.05.0542
Rades, Dirk ; Fehlauer, Fabian ; Schulte, Rainer ; Veninga, Theo ; Stalpers, Lukas J A ; Basic, Hiba ; Bajrovic, Amira ; Hoskin, Peter J. ; Tribius, Silke ; Wildfang, Ingeborg ; Rudat, Volker ; Engenhart-Cabilic, Rita ; Karstens, Johann H. ; Alberti, Winfried ; Dunst, Juergen ; Schild, Steven E. / Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 21. pp. 3388-3393.
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abstract = "Purpose: To evaluate potential prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression (MSCC). Patients and Methods: The following potential prognostic factors were investigated retrospectively in 1,852 patients irradiated for MSCC: age, sex, performance status, primary tumor, interval between tumor diagnosis and MSCC (≤ 15 v > 15 months), number of involved vertebrae (one to two v ≥ three), other bone metastases, visceral metastases, pretreatment ambulatory status, time of developing motor deficits before radiotherapy (faster, 1 to 14 v slower, > 14 days), and radiation schedule (short-course v long-course radiotherapy). Results: On univariate analysis, improved local control of MSCC was associated significantly with favorable histology (breast cancer, prostate cancer, lymphoma/myeloma), no visceral metastases, and long-course radiotherapy. On multivariate analysis, absence of visceral metastases and radiation schedule maintained significance. On univariate analysis, improved survival was associated significantly with female sex, favorable histology, no visceral or other bone metastases, good performance status, being ambulatory before radiotherapy, longer interval between tumor diagnosis and MSCC, and slower development of motor deficits before radiotherapy. Long-course radiotherapy showed a trend. On multivariate analysis, histology, visceral metastases, other bone metastases, ambulatory status before radiotherapy, interval between tumor diagnosis and MSCC, and time of developing motor deficits maintained significance. Conclusion: Poorer local control after radiotherapy for MSCC is associated with visceral metastases and short-course radiotherapy. Long-course radiotherapy seems preferable for patients with more favorable prognoses, given that these patients may live long enough to develop MSCC recurrences. Long-term survival after radiotherapy for MSCC may be predicted if several prognostic factors are considered.",
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T1 - Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression

AU - Rades, Dirk

AU - Fehlauer, Fabian

AU - Schulte, Rainer

AU - Veninga, Theo

AU - Stalpers, Lukas J A

AU - Basic, Hiba

AU - Bajrovic, Amira

AU - Hoskin, Peter J.

AU - Tribius, Silke

AU - Wildfang, Ingeborg

AU - Rudat, Volker

AU - Engenhart-Cabilic, Rita

AU - Karstens, Johann H.

AU - Alberti, Winfried

AU - Dunst, Juergen

AU - Schild, Steven E.

PY - 2006/7/20

Y1 - 2006/7/20

N2 - Purpose: To evaluate potential prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression (MSCC). Patients and Methods: The following potential prognostic factors were investigated retrospectively in 1,852 patients irradiated for MSCC: age, sex, performance status, primary tumor, interval between tumor diagnosis and MSCC (≤ 15 v > 15 months), number of involved vertebrae (one to two v ≥ three), other bone metastases, visceral metastases, pretreatment ambulatory status, time of developing motor deficits before radiotherapy (faster, 1 to 14 v slower, > 14 days), and radiation schedule (short-course v long-course radiotherapy). Results: On univariate analysis, improved local control of MSCC was associated significantly with favorable histology (breast cancer, prostate cancer, lymphoma/myeloma), no visceral metastases, and long-course radiotherapy. On multivariate analysis, absence of visceral metastases and radiation schedule maintained significance. On univariate analysis, improved survival was associated significantly with female sex, favorable histology, no visceral or other bone metastases, good performance status, being ambulatory before radiotherapy, longer interval between tumor diagnosis and MSCC, and slower development of motor deficits before radiotherapy. Long-course radiotherapy showed a trend. On multivariate analysis, histology, visceral metastases, other bone metastases, ambulatory status before radiotherapy, interval between tumor diagnosis and MSCC, and time of developing motor deficits maintained significance. Conclusion: Poorer local control after radiotherapy for MSCC is associated with visceral metastases and short-course radiotherapy. Long-course radiotherapy seems preferable for patients with more favorable prognoses, given that these patients may live long enough to develop MSCC recurrences. Long-term survival after radiotherapy for MSCC may be predicted if several prognostic factors are considered.

AB - Purpose: To evaluate potential prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression (MSCC). Patients and Methods: The following potential prognostic factors were investigated retrospectively in 1,852 patients irradiated for MSCC: age, sex, performance status, primary tumor, interval between tumor diagnosis and MSCC (≤ 15 v > 15 months), number of involved vertebrae (one to two v ≥ three), other bone metastases, visceral metastases, pretreatment ambulatory status, time of developing motor deficits before radiotherapy (faster, 1 to 14 v slower, > 14 days), and radiation schedule (short-course v long-course radiotherapy). Results: On univariate analysis, improved local control of MSCC was associated significantly with favorable histology (breast cancer, prostate cancer, lymphoma/myeloma), no visceral metastases, and long-course radiotherapy. On multivariate analysis, absence of visceral metastases and radiation schedule maintained significance. On univariate analysis, improved survival was associated significantly with female sex, favorable histology, no visceral or other bone metastases, good performance status, being ambulatory before radiotherapy, longer interval between tumor diagnosis and MSCC, and slower development of motor deficits before radiotherapy. Long-course radiotherapy showed a trend. On multivariate analysis, histology, visceral metastases, other bone metastases, ambulatory status before radiotherapy, interval between tumor diagnosis and MSCC, and time of developing motor deficits maintained significance. Conclusion: Poorer local control after radiotherapy for MSCC is associated with visceral metastases and short-course radiotherapy. Long-course radiotherapy seems preferable for patients with more favorable prognoses, given that these patients may live long enough to develop MSCC recurrences. Long-term survival after radiotherapy for MSCC may be predicted if several prognostic factors are considered.

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