The first score predicting overall survival in patients with metastatic spinal cord compression

Abstract Background Patients with metastatic spinal cord compression (MSCC) and favorable survival prognoses can benefit from radiation doses greater than 30Gy in 10 fractions in terms of improved local progression-free survival (LPFS) and overall survival (OS). Methods/design This prospective study mainly investigates LPFS after precision radiotherapy (volumetric modulated arc therapy or stereotactic body radiotherapy) with 18 × 2.33Gy in 3.5 weeks. LPFS is defined as freedom from progression of motor deficits during radiotherapy and an in-field recurrence of MSCC following radiotherapy. The maximum relative dose allowed to the spinal cord is 101.5% of the prescribed dose, resulting in an equivalent dose in 2Gy-fractions (EQD2) for radiation myelopathy is 45.5Gy, which is below the tolerance dose of 50Gy according to the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC). The EQD2 of this regimen for tumor cell kill is 43.1Gy, which is 33% higher than for 30Gy in 10 fractions (EQD2 = 32.5Gy). Primary endpoint is LPFS at 12 months after radiotherapy. Secondary endpoints include the effect of 18 × 2.33Gy on motor function, ambulatory status, sensory function, sphincter dysfunction, LPFS at other follow-up times, overall survival, pain relief, relief of distress and toxicity. Follow-up visits for all endpoints will be performed directly and at 1, 3, 6, 9 and 12 months after radiotherapy. A total of 65 patients are required for the prospective part of the study. These patients will be compared to a historical control group of at least 235 patients receiving conventional radiotherapy with 10x3Gy in 2 weeks. Discussion If precision radiotherapy with 18 × 2.33Gy results in significantly better LPFS than 10x3Gy of conventional radiotherapy, this regimen should be strongly considered for patients with MSCC and favorable survival prognoses. Trial registration Clinicaltrials.gov NCT04043156. Registered 30-07-2019.

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Prognostic Discrepancy on Overall Survival Between Ambulatory and Nonambulatory Patients with Metastatic Spinal Cord Compression

World Neurosurgery ◽

10.1016/j.wneu.2018.09.102 ◽

2019 ◽

Vol 121 ◽

pp. e322-e332 ◽

Cited By ~ 3

Author(s):

Jiang-tao Feng ◽

Xiong-gang Yang ◽

Feng Wang ◽

Kun-chi Hua ◽

Yong-heng Liu ◽

...

Keyword(s):

Spinal Cord ◽

Overall Survival ◽

Spinal Cord Compression ◽

Cord Compression ◽

Metastatic Spinal Cord Compression

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2500 ORAL A score predicting overall survival in patients with metastatic spinal cord compression

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(07)70903-5 ◽

2007 ◽

Vol 5 (4) ◽

pp. 227

Author(s):

D. Rades ◽

J. Dunst ◽

S.E. Schild

Keyword(s):

Spinal Cord ◽

Overall Survival ◽

Spinal Cord Compression ◽

Cord Compression ◽

Metastatic Spinal Cord Compression

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Metastatic Spinal Cord Compression as the First Manifestation of Malignancy – A Retrospective Study of Surgical Outcome from Single Institution Spine Tumor Registry

10.21203/rs.3.rs-574132/v1 ◽

2021 ◽

Author(s):

Ue-Cheung Ho ◽

Dar-Ming Lai ◽

Fu-Ren Xiao ◽

Shih-Hung Yang ◽

Chang-Mu Chen ◽

...

Keyword(s):

Spinal Cord ◽

Overall Survival ◽

Spinal Cord Compression ◽

Surgical Outcome ◽

Progression Free Survival ◽

Cord Compression ◽

Metastatic Spinal Cord Compression ◽

Duration Of Symptoms ◽

Free Survival ◽

Significant Difference

Abstract Given the limited studies addressing the issue about the effect of different surgical modalities for metastatic spinal cord compression (MSCC) as the first malignancy manifestation, we conducted a retrospective case-control study to evaluate the surgical outcome of MSCC as the first malignancy manifestation. A total of 59 patients who were suspected of having metastatic spinal cord compression and underwent surgery from 2008 to 2017 were enrolled in the study. All patients were categorized into either ‘debulking group’ or ‘palliative group’. The primary outcome was progression-free survival (PFS). The secondary outcomes were overall survival (OS), Frankel scale, and Karnofsky scores. All the outcomes were analyzed with a data cutoff of December 31, 2017. There was a significant difference between groups in progression-free survival (PFS) (p = 0.0036). However, there was no significant difference between groups in the overall survival (OS) (p = 0.8669). Age of onset, gender, duration of symptoms, and location of spinal metastasis, initial Frankel, initial Tomita scores, and initial Karnofsky performance scale showed no significant differences between groups. In conclusion, debulking surgery was shown to provide better neurological recoveries and could be considered first in patients with metastatic spinal cord compression as the first malignancy manifestation.

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