Radiotherapy with 15 × 2.633 Gy vs. 20 × 2.0 Gy in Patients with Malignant Spinal Cord Compression and Favorable Survival Prognoses: A Secondary Analysis of the RAMSES-01 Trial.

Autor:	Rades, Dirk, Lomidze, Darejan, Jankarashvili, Natalia, Lopez Campos, Fernando, Navarro-Martin, Arturo, Segedin, Barbara, Groselj, Blaz, Staackmann, Christian, Yu, Nathan Y., Cacicedo, Jon
Předmět:	SPINAL cord tumors SECONDARY analysis NEUROSURGERY RESEARCH funding LOGISTIC regression analysis SPINAL cord compression CANCER patients FUNCTIONAL status DESCRIPTIVE statistics PSYCHOLOGY of movement RADIATION doses PROGRESSION-free survival PROPORTIONAL hazards models OVERALL survival
Zdroj:	Cancers; Oct2024, Vol. 16 Issue 20, p3436, 12p
Abstrakt:	Simple Summary: This study compared 15 × 2.633 Gy over three weeks to 20 × 2.0 Gy over four weeks for malignant spinal cord compression (MSCC) in patients with favorable survival prognoses not receiving upfront neurosurgery. After a propensity score adjustment of the Cox and logistic regression models, no significant differences were observed regarding local progression-free survival (LPFS), overall survival (OS), and post-treatment ambulatory status. A trend (p = 0.073) was found in favor of 15 × 2.633 Gy regarding improvement of motor function. Considering the limitations of our study, 15 × 2.633 Gy may be preferable for patients with MSCC with favorable prognosis. Many patients with malignant spinal cord compression (MSCC) who are not candidates for neurosurgery receive radiotherapy alone. This study compared 15 × 2.633 Gy over three weeks to 20 × 2.0 Gy over four weeks in patients with favorable survival prognoses. The outcomes of 34 patients treated with 15 × 2.633 Gy (equivalent dose 41.6 Gy10) in the RAMSES-01 trial were compared to 239 patients from an existing database receiving 20 × 2.0 Gy using propensity-score-adjusted Cox and logistic regression models. All patients had favorable survival prognoses. Endpoints included local progression-free survival (LPFS), improvement of motor function, post-treatment ambulatory status, and overall survival (OS). After propensity score adjustment, the 12-month rates of LPFS and OS were 98.1% (RAMSES-01 cohort) vs. 91.6% (p = 0.265) and 79.1% vs. 82.2% (p = 0.704), respectively. Regarding improvement of motor function, 15 × 2.633 Gy appeared superior (p = 0.073). No significant difference was observed regarding ambulatory status (p = 0.822). The three-week regimen for MSCC has similar outcomes and reduces treatment time when compared to a four-week regimen. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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