TY - JOUR
T1 - Short-course radiotherapy is not optimal for spinal cord compression due to myeloma
AU - Rades, Dirk
AU - Hoskin, Peter J.
AU - Stalpers, Lukas J.A.
AU - Schulte, Rainer
AU - Poortmans, Philip
AU - Veninga, Theo
AU - Dahm-Daphi, Jochen
AU - Obralic, Nermina
AU - Wildfang, Ingeborg
AU - Bahrehmand, Roja
AU - Engenhart-Cabilic, Rita
AU - Schild, Steven E.
PY - 2006/4/1
Y1 - 2006/4/1
N2 - Purpose: To investigate the suitability of short-course radiotherapy (RT) for spinal cord compression (SCC) in myeloma patients. Methods and Materials: Data for 172 myeloma patients irradiated between January 1994 and December 2004 for SCC were retrospectively evaluated. Short-course RT (1 × 8 Gy, 5 × 4 Gy, n = 61) and long-course RT (10 × 3 Gy, 15 × 2.5 Gy, 20 × 2 Gy, n = 111) were compared for functional outcome up to 24 months after RT. In addition, 10 potential prognostic factors were investigated. Results: Improvement of motor function occurred in 90 patients (52%). Forty-seven percent of nonambulatory patients regained the ability to walk. Functional outcome was significantly influenced by the time of developing motor deficits before RT. Improvement of motor function was more frequent after long-course RT than after short-course RT: 59% vs. 39% (p = 0.10) at 1 month, 67% vs. 43% (p = 0.043) at 6 months, 76% vs. 40% (p = 0.003) at 12 months, 78% vs. 43% (p = 0.07) at 18 months, and 83% v 54% (p = 0.33) at 24 months. A subgroup analysis of the long-course RT group demonstrated a similar functional outcome for 10 × 3 Gy when compared with 15 × 2.5 Gy and 20 × 2 Gy. Conclusions: Long-course RT is preferable for SCC in myeloma patients because it resulted in better functional outcome than short-course RT. Treatment with 10 × 3 Gy can be considered appropriate.
AB - Purpose: To investigate the suitability of short-course radiotherapy (RT) for spinal cord compression (SCC) in myeloma patients. Methods and Materials: Data for 172 myeloma patients irradiated between January 1994 and December 2004 for SCC were retrospectively evaluated. Short-course RT (1 × 8 Gy, 5 × 4 Gy, n = 61) and long-course RT (10 × 3 Gy, 15 × 2.5 Gy, 20 × 2 Gy, n = 111) were compared for functional outcome up to 24 months after RT. In addition, 10 potential prognostic factors were investigated. Results: Improvement of motor function occurred in 90 patients (52%). Forty-seven percent of nonambulatory patients regained the ability to walk. Functional outcome was significantly influenced by the time of developing motor deficits before RT. Improvement of motor function was more frequent after long-course RT than after short-course RT: 59% vs. 39% (p = 0.10) at 1 month, 67% vs. 43% (p = 0.043) at 6 months, 76% vs. 40% (p = 0.003) at 12 months, 78% vs. 43% (p = 0.07) at 18 months, and 83% v 54% (p = 0.33) at 24 months. A subgroup analysis of the long-course RT group demonstrated a similar functional outcome for 10 × 3 Gy when compared with 15 × 2.5 Gy and 20 × 2 Gy. Conclusions: Long-course RT is preferable for SCC in myeloma patients because it resulted in better functional outcome than short-course RT. Treatment with 10 × 3 Gy can be considered appropriate.
KW - Myeloma
KW - Radiotherapy
KW - Spinal cord compression
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U2 - 10.1016/j.ijrobp.2005.10.018
DO - 10.1016/j.ijrobp.2005.10.018
M3 - Article
C2 - 16413695
AN - SCOPUS:33645359733
SN - 0360-3016
VL - 64
SP - 1452
EP - 1457
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 5
ER -