BACKGROUND AND PURPOSE: In a previous randomized trial we showed that the short-course radiotherapy (RT) regimen of 8 Gy x 2 was feasible in patients with metastatic spinal cord compression (MSCC) and short life expectancy. This phase III trial was planned to determine whether in the same category of patients 8Gy single-dose is as effective as 8 Gy x 2. MATERIALS AND METHODS: Three hundred and twenty-seven patients with MSCC and short life expectancy were randomly assigned to a short-course of 8 Gy x 2 or to 8 Gy single-dose RT. Median follow-up was 31 months (range, 4-58). RESULTS:A total of 303 (93%) patients are assessable, 150 treated with the short-course and 153 with the single-dose RT. No difference in response was found between the two RT schedules adopted. Median duration of response was 5 and 4.5 months for short-course and single-dose RT (p=0.4), respectively. The median overall survival was 4 months for all cases. Light acute toxicity was registered in a minority of cases. Late toxicity was never recorded. CONCLUSIONS: Both RT schedules adopted were effective. As already shown in several trials evaluating RT regimens in uncomplicated painful bone metastases, also MSCC patients may achieve palliation with minimal toxicity and inconvenience with a single-dose of 8 Gy.
RCT Entities:
BACKGROUND AND PURPOSE: In a previous randomized trial we showed that the short-course radiotherapy (RT) regimen of 8 Gy x 2 was feasible in patients with metastatic spinal cord compression (MSCC) and short life expectancy. This phase III trial was planned to determine whether in the same category of patients 8 Gy single-dose is as effective as 8 Gy x 2. MATERIALS AND METHODS: Three hundred and twenty-seven patients with MSCC and short life expectancy were randomly assigned to a short-course of 8 Gy x 2 or to 8 Gy single-dose RT. Median follow-up was 31 months (range, 4-58). RESULTS: A total of 303 (93%) patients are assessable, 150 treated with the short-course and 153 with the single-dose RT. No difference in response was found between the two RT schedules adopted. Median duration of response was 5 and 4.5 months for short-course and single-dose RT (p=0.4), respectively. The median overall survival was 4 months for all cases. Light acute toxicity was registered in a minority of cases. Late toxicity was never recorded. CONCLUSIONS: Both RT schedules adopted were effective. As already shown in several trials evaluating RT regimens in uncomplicated painful bone metastases, also MSCC patients may achieve palliation with minimal toxicity and inconvenience with a single-dose of 8 Gy.
Authors: David D Howell; Jennifer L James; William F Hartsell; Mohan Suntharalingam; Mitchell Machtay; John H Suh; William F Demas; Howard M Sandler; Lisa A Kachnic; Lawrence B Berk Journal: Cancer Date: 2012-11-16 Impact factor: 6.860
Authors: Susannah G Ellsworth; Sara R Alcorn; Russell K Hales; Todd R McNutt; Theodore L DeWeese; Thomas J Smith Journal: Int J Radiat Oncol Biol Phys Date: 2014-07-08 Impact factor: 7.038
Authors: Laurens Bollen; Yvette M van der Linden; Willem Pondaag; Marta Fiocco; Bas P M Pattynama; Corrie A M Marijnen; Rob G H H Nelissen; Wilco C Peul; P D Sander Dijkstra Journal: Neuro Oncol Date: 2014-07 Impact factor: 12.300