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Title: Radiotherapy of metastatic spinal cord compression in very elderly patients

Abstract

Purpose: Owing to the aging of the population, the proportion of elderly patients receiving cancer treatment has increased. This study investigated the results of radiotherapy (RT) for metastatic spinal cord compression (MSCC) in the very elderly, because few data are available for these patients. Methods and Materials: The data from 308 patients aged {>=}75 years who received short-course (treatment time 1-5 days) or long-course RT (2-4 weeks) for MSCC were retrospectively analyzed for functional outcome, local control, and survival. Furthermore, nine potential prognostic factors were investigated: gender, performance status, interval from tumor diagnosis to MSCC, tumor type, number of involved vertebrae, other bone or visceral metastases, ambulatory status, and speed at which motor deficits developed. Results: Improvement of motor deficits occurred in 25% of patients, with no further progression of MSCC in an additional 59%. The 1-year local control and survival rate was 92% and 43%, respectively. Improved functional outcomes were associated with ambulatory status and slower developing motor deficits. Improved local control resulted from long-course RT. Improved survival was associated with a longer interval from tumor diagnosis to MSCC, tumor type (breast/prostate cancer, myeloma/lymphoma), lack of visceral or other bone metastases, ambulatory status, and a slower development of motormore » deficits. Conclusion: Short- and long-course RT are similarly effective in patients aged {>=}75 years regarding functional outcome and survival. Long-course RT provided better local control. Patients with better expected survival should receive long-course RT and others short-course RT. The criteria for selection of an appropriate regimen for MSCC in very elderly patients should be the same as for younger individuals.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8]
  1. Department of Radiation Oncology, University Hospital Schleswig-Holstein, Luebeck (Germany) and Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg (Germany). E-mail: Rades.Dirk@gmx.net
  2. Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex (United Kingdom)
  3. Department of Radiation Oncology, Hannover Medical School, Hannover (Germany)
  4. Department of Radiation Oncology, St. Josef Hospital, Ruhr University, Bochum (Germany)
  5. Department of Radiation Oncology, Dr. Bernard Verbeeten Institute, Tilburg (Netherlands)
  6. Department of Radiotherapy, Academic Medical Center, Amsterdam (Netherlands)
  7. Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, AZ (United States)
  8. Department of Radiation Oncology, University Hospital Schleswig-Holstein, Luebeck (Germany)
Publication Date:
OSTI Identifier:
20850323
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.08.011; PII: S0360-3016(06)02742-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AGING; DIAGNOSIS; ELDERLY PEOPLE; LYMPHOMAS; MAMMARY GLANDS; METASTASES; PATIENTS; PERFORMANCE; PROSTATE; RADIOTHERAPY; SPINAL CORD; VERTEBRAE

Citation Formats

Rades, Dirk, Hoskin, Peter J., Karstens, Johann H., Rudat, Volker, Veninga, Theo, Stalpers, Lukas J.A., Schild, Steven E., and Dunst, Juergen. Radiotherapy of metastatic spinal cord compression in very elderly patients. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.08.011.
Rades, Dirk, Hoskin, Peter J., Karstens, Johann H., Rudat, Volker, Veninga, Theo, Stalpers, Lukas J.A., Schild, Steven E., & Dunst, Juergen. Radiotherapy of metastatic spinal cord compression in very elderly patients. United States. doi:10.1016/j.ijrobp.2006.08.011.
Rades, Dirk, Hoskin, Peter J., Karstens, Johann H., Rudat, Volker, Veninga, Theo, Stalpers, Lukas J.A., Schild, Steven E., and Dunst, Juergen. Mon . "Radiotherapy of metastatic spinal cord compression in very elderly patients". United States. doi:10.1016/j.ijrobp.2006.08.011.
@article{osti_20850323,
title = {Radiotherapy of metastatic spinal cord compression in very elderly patients},
author = {Rades, Dirk and Hoskin, Peter J. and Karstens, Johann H. and Rudat, Volker and Veninga, Theo and Stalpers, Lukas J.A. and Schild, Steven E. and Dunst, Juergen},
abstractNote = {Purpose: Owing to the aging of the population, the proportion of elderly patients receiving cancer treatment has increased. This study investigated the results of radiotherapy (RT) for metastatic spinal cord compression (MSCC) in the very elderly, because few data are available for these patients. Methods and Materials: The data from 308 patients aged {>=}75 years who received short-course (treatment time 1-5 days) or long-course RT (2-4 weeks) for MSCC were retrospectively analyzed for functional outcome, local control, and survival. Furthermore, nine potential prognostic factors were investigated: gender, performance status, interval from tumor diagnosis to MSCC, tumor type, number of involved vertebrae, other bone or visceral metastases, ambulatory status, and speed at which motor deficits developed. Results: Improvement of motor deficits occurred in 25% of patients, with no further progression of MSCC in an additional 59%. The 1-year local control and survival rate was 92% and 43%, respectively. Improved functional outcomes were associated with ambulatory status and slower developing motor deficits. Improved local control resulted from long-course RT. Improved survival was associated with a longer interval from tumor diagnosis to MSCC, tumor type (breast/prostate cancer, myeloma/lymphoma), lack of visceral or other bone metastases, ambulatory status, and a slower development of motor deficits. Conclusion: Short- and long-course RT are similarly effective in patients aged {>=}75 years regarding functional outcome and survival. Long-course RT provided better local control. Patients with better expected survival should receive long-course RT and others short-course RT. The criteria for selection of an appropriate regimen for MSCC in very elderly patients should be the same as for younger individuals.},
doi = {10.1016/j.ijrobp.2006.08.011},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 67,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 2007},
month = {Mon Jan 01 00:00:00 EST 2007}
}