Dirk Rades1, Antonio J Conde-Moreno2, Jon Cacicedo3, Barbara Segedin4, Theo Veninga5, Steven E Schild6. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Rades.Dirk@gmx.net. 2. Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón, Spain. 3. Department of Radiation Oncology, Cruces University Hospital, Barakaldo, Vizcaya, Spain. 4. Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia. 5. Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, the Netherlands. 6. Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, AZ, U.S.A.
Abstract
AIM: Metastatic spinal cord compression (MSCC) is an oncological emergency. Many elderly patients cannot tolerate intensive treatment and need individual approaches accounting for a patient's remaining lifetime. The goal of the present study was to develop a survival score for elderly prostate cancer patients with MSCC. PATIENTS AND METHODS: Nine characteristics were analyzed in 243 patients: age, performance status, interval from prostate cancer diagnosis until MSCC, affected vertebrae, ambulatory status, further bone lesions, visceral metastases, time developing motor deficits, fractionation schedule. RESULTS: Pre-radiotherapy ambulatory status (p<0.001), visceral metastases (p<0.001) and time developing motor deficits (p<0.001) were significant for survival on Cox regression analysis and included in the survival score. Four groups were defined: 9-12, 13-16, 17-19 and 21-23 points. Six-month survival rates were 7%, 28%, 71% and 95%, respectively (p<0.001). CONCLUSION: The present study identified four groups with different survival probabilities that require treatment strategies with different priorities ranging from symptom control to prolongation of life. Copyright
AIM: Metastatic spinal cord compression (MSCC) is an oncological emergency. Many elderly patients cannot tolerate intensive treatment and need individual approaches accounting for a patient's remaining lifetime. The goal of the present study was to develop a survival score for elderly prostate cancerpatients with MSCC. PATIENTS AND METHODS: Nine characteristics were analyzed in 243 patients: age, performance status, interval from prostate cancer diagnosis until MSCC, affected vertebrae, ambulatory status, further bone lesions, visceral metastases, time developing motor deficits, fractionation schedule. RESULTS: Pre-radiotherapy ambulatory status (p<0.001), visceral metastases (p<0.001) and time developing motor deficits (p<0.001) were significant for survival on Cox regression analysis and included in the survival score. Four groups were defined: 9-12, 13-16, 17-19 and 21-23 points. Six-month survival rates were 7%, 28%, 71% and 95%, respectively (p<0.001). CONCLUSION: The present study identified four groups with different survival probabilities that require treatment strategies with different priorities ranging from symptom control to prolongation of life. Copyright