Radiotherapy with 4 Gy × 5 versus 3 Gy × 10 for metastatic epidural spinal cord compression: Final results of the SCORE-2 Trial (ARO 2009/01)

Dirk Rades, Barbara Šegedin, Antonio J. Conde-Moreno, Raquel Garcia, Ana Perpar, Michaela Metz, Harun Badakhshi, Andreas Schreiber, Mirko Nitsche, Peter Hipp, Wolfgang Schulze, Irenaeus A. Adamietz, Darius Norkus, Volker Rudat, Jon Cacicedo, Steven E. Schild

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Purpose To compare short-course radiotherapy (RT) (4 Gy × 5) to longer-course RT (3 Gy × 10) for metastatic epidural spinal cord compression (MESCC). Patients and Methods Two-hundred three patients with MESCC and poor to intermediate expected survival were randomly assigned to 4 Gy × 5 in 1 week (n = 101) or 3 Gy × 10 in 2 weeks (n = 102). Patients were stratified according to ambulatory status, time developing motor deficits, and primary tumor type. Seventyeight and 77 patients, respectively, were evaluable for the primary end point, 1-month overall response regarding motor function defined as improvement or no further progression of motor deficits. Other study end points included ambulatory status, local progression-free survival, and overall survival. End points were evaluated immediately after RT and at 1, 3, and 6 months thereafter. Results At 1 month, overall response rates regarding motor function were 87.2% after 4 Gy × 5 and 89.6% after 3 Gy × 10 (P = .73). Improvement rates were 38.5% and 44.2%, respectively, no further progression rates 48.7% and 45.5%, respectively, and deterioration rates 12.8% and 10.4%, respectively (P = .44). Ambulatory rates at 1 month were 71.8% and 74.0%, respectively (P = .86). At other times after RT, the results were also not significantly different. Six-month local progressionfree survival was 75.2% after 4 Gy × 5 and 81.8% after 3 Gy × 10 (P = .51); 6-month overall survival was 42.3% and 37.8% (P = .68). Conclusion Short-course RT with 4 Gy35 was not significantly inferior to 3 Gy310 in patients with MESCC and poor to intermediate expected survival.

Original languageEnglish (US)
Pages (from-to)597-602
Number of pages6
JournalJournal of Clinical Oncology
Volume34
Issue number6
DOIs
StatePublished - Feb 20 2016

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Rades, D., Šegedin, B., Conde-Moreno, A. J., Garcia, R., Perpar, A., Metz, M., Badakhshi, H., Schreiber, A., Nitsche, M., Hipp, P., Schulze, W., Adamietz, I. A., Norkus, D., Rudat, V., Cacicedo, J., & Schild, S. E. (2016). Radiotherapy with 4 Gy × 5 versus 3 Gy × 10 for metastatic epidural spinal cord compression: Final results of the SCORE-2 Trial (ARO 2009/01). Journal of Clinical Oncology, 34(6), 597-602. https://doi.org/10.1200/JCO.2015.64.0862