Short-course radiotherapy (8 Gy × 2) in metastatic spinal cord compression: An effective and feasible treatment
| Autor: | Paolo Latini, Marco Lupattelli, E. Corgna, Ernesto Maranzano, Elisabetta Perrucci, S. Beneventi |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.medical_treatment Central nervous system disease Median follow-up medicine Back pain Humans Radiology Nuclear Medicine and imaging Survival analysis Aged Paresis Spinal Neoplasms Radiation Performance status business.industry Radiotherapy Dosage Middle Aged medicine.disease Survival Analysis Surgery Radiation therapy Treatment Outcome Oncology Feasibility Studies Female Radiology medicine.symptom business Spinal Cord Compression Esophagitis Follow-Up Studies |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 38:1037-1044 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/s0360-3016(97)00128-4 |
| Popis: | Purpose: To evalute the clinical outcome and toxicity of a short-course regiment of radiotherapy (RT) in selected metastatic spinal cord compression (MSCC) patients. Methods and Materials: Between 1993 and 1995, 53 consecutive patients with MSCC from low radio-responsive primary tumors (non small cell lung, kidney, head and neck and gastrointestinal carcinomas, melanoma and sarcomas), or more radio-responsive ones (breast and prostate carcinomas, myeloma and lymphomas) with paresis, plegia, low performance status (PS ECOG ≥ 2), and/or short life expectation, underwent short-course RT; a single fraction of 8 Gy repeated after 1 week in responders or stable patients, for a total dose of 16 Gy. Of 49 (92%) evaluable cases, 4 (8%) underwent surgery plus RT and the other 45 RT alone. Medium doses of parenteral dexamenthasone (8 mg × 2/d) were given in all cases and precautional anti-emetics to those treated with fields covering the upper abdomen (20 of 49 cases). Median follow up was 25 months (range, 6–34). Response was assessed according to back pain, and motor and bladder capacity before and after RT. Results: Pain relief was achieved in 67% of patients and motor function response rate reched 63%. Early diganosis and therapy were very important in predicting response to RT; all but two (91%) pretreatment walking patients and all but one (98%) with good bladder function preserved these cpacities. On the contrary, when diagnosis was late, only 38% of nonambulatory patients and 44% of those with bladder retention improved. Median survival was 5 months, with a 30% probability of survival for 1 year. Length of survival was significantly longer for patients able to walk before and/or after RT. Good aggreement between survival and duration of response was found with no evidence of relapse in the irradiated spine. Sickness appeared only in a few cases. Slight esophagitis was more frequent: dyspahia for solid foods in one-third of patients irradiated on the thoracic spine. Late toxicity was never recorded. Conclusion: The short-course RT adopted gave a cliical outcome comparable with that resulting from more protracted regimens with only slight side effects. The use of a few large treatment fractions could be explored considering the associated advantages for patients and radiotherapy centers often overloaded by long patient waiting lists. |
| Databáze: | OpenAIRE |
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