A matched-pair analysis comparing 5×4 Gy and 10×3 Gy for metastatic spinal cord compression (MSCC) in patients with favorable survival prognoses.

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A matched-pair analysis comparing 5×4 Gy and 10×3 Gy for metastatic spinal cord compression (MSCC) in patients with favorable survival prognoses.

Radiat Oncol. 2015;10:90

Authors: Rades D, Huttenlocher S, Veninga T, Bajrovic A, Bremer M, Rudat V, Schild SE

Abstract
BACKGROUND: It is currently not possible to get an approval of our ethics committee for a randomized trial cmparing 5×4 Gy and 10×3 Gy for MSCC that includes patients with favorable survival prognoses. Therefore, this matched-pair study following strict matching criteria was perfomed instead.
METHODS: In this study, 142 receiving 5×4 Gy were retrospectively matched (1:1) to 142 patients receiving 10×3 Gy with respect to ten characteristics. These characteristics included age, gender, performance status, tumor type, involved vertebrae, other bone metastases, visceral metastases, interval between tumor diagnosis and MSCC, pre-RT ambulatory status, and time developing motor deficits.
RESULTS: On multivariate analysis, post-RT motor function was associated with performance status (p<0.001), tumor type (p < 0.001), and time developing motor deficits (p<0.001). RT was successful in 76% of patients receiving 5×4 Gy and 69% receiving 10×3 Gy (p=0.14). Pre.RT ambulatory status showed a strong trend with respect to local control (LC) of MSCC in the multivariate analysis (p=0.058). 1-year LC rates were 87% after 5×4 Gy and 93% after 10×3 Gy (p=0.16). On multivariate analysis, survival (OS) was associated with performance score (p<0.001), visceral metastases (p<0.001), and pre-RT ambulatory status (p=0.004). 1-year OS rates were 68% after 5×4 Gy and 73% after 10×3 Gy (p = 0.64).
CONCLUSIONS: In patients irradiated for MSCC who had favorable survival prognoses, post-RT motor function, LC and OS were not significantly different after 5×4 Gy and after 10×3 Gy.

PMID: 25889036 [PubMed – indexed for MEDLINE]