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

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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

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Spinal Cord Compression
Radiotherapy
Survival
Disease-Free Survival
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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

In: Journal of Clinical Oncology, Vol. 34, No. 6, 20.02.2016, p. 597-602.

Research output: Contribution to journalArticle

Rades, D, Šegedin, B, Conde-Moreno, AJ, Garcia, R, Perpar, A, Metz, M, Badakhshi, H, Schreiber, A, Nitsche, M, Hipp, P, Schulze, W, Adamietz, IA, Norkus, D, Rudat, V, Cacicedo, J & Schild, SE 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, vol. 34, no. 6, pp. 597-602. https://doi.org/10.1200/JCO.2015.64.0862
Rades, Dirk ; Šegedin, Barbara ; Conde-Moreno, Antonio J. ; Garcia, Raquel ; Perpar, Ana ; Metz, Michaela ; Badakhshi, Harun ; Schreiber, Andreas ; Nitsche, Mirko ; Hipp, Peter ; Schulze, Wolfgang ; Adamietz, Irenaeus A. ; Norkus, Darius ; Rudat, Volker ; Cacicedo, Jon ; Schild, Steven E. / 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). In: Journal of Clinical Oncology. 2016 ; Vol. 34, No. 6. pp. 597-602.
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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.",
author = "Dirk Rades and Barbara Šegedin and Conde-Moreno, {Antonio J.} and Raquel Garcia and Ana Perpar and Michaela Metz and Harun Badakhshi and Andreas Schreiber and Mirko Nitsche and Peter Hipp and Wolfgang Schulze and Adamietz, {Irenaeus A.} and Darius Norkus and Volker Rudat and Jon Cacicedo and Schild, {Steven E.}",
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T1 - Radiotherapy with 4 Gy × 5 versus 3 Gy × 10 for metastatic epidural spinal cord compression

T2 - Final results of the SCORE-2 Trial (ARO 2009/01)

AU - Rades, Dirk

AU - Šegedin, Barbara

AU - Conde-Moreno, Antonio J.

AU - Garcia, Raquel

AU - Perpar, Ana

AU - Metz, Michaela

AU - Badakhshi, Harun

AU - Schreiber, Andreas

AU - Nitsche, Mirko

AU - Hipp, Peter

AU - Schulze, Wolfgang

AU - Adamietz, Irenaeus A.

AU - Norkus, Darius

AU - Rudat, Volker

AU - Cacicedo, Jon

AU - Schild, Steven E.

PY - 2016/2/20

Y1 - 2016/2/20

N2 - 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.

AB - 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.

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