Comparison of Two Radiotherapy Regimens for Metastatic Spinal Cord Compression: Subgroup Analyses from a Randomized Trial

Anticancer Res. 2018 Feb;38(2):1009-1015. doi: 10.21873/anticanres.12316.

Abstract

Background/aim: According to our randomized trial, 5×4Gy was comparable to 10×3Gy for metastatic spinal cord compression. Since it remained unclear whether findings applied to poor and intermediate prognoses patients, subgroup analyses were performed.

Patients and methods: In patients with poor prognoses, 58 received 5×4Gy, 53 received 10×3Gy. In intermediate-prognoses patients, numbers were 43 and 49.

Results: In patients with poor prognoses, 1-month overall response (OR) was 85% after 5×4Gy and 10×3Gy (p=0.99), improvement 38% vs. 42%, ambulatory status 60% vs. 64% (p=0.83), 6-month local progression-free survival (LPFS) 75% vs. 69% (p=0.74) and 6-month overall survival (OS) 26% vs. 19% (p=0.43). In patients with intermediate prognoses, 1-month OR was 89% after 5×4Gy and 93% after 10×3Gy (p=0.85), improvement 39% vs. 45%, ambulatory status 84% vs. 82% (p=0.90), 6-month LPFS 79% vs. 92% (p=0.17) and 6-months OS 65% vs. 58% (p=0.65).

Conclusion: 5×4Gy was not significantly inferior to 10x3Gy in both subgroups.

Keywords: Metastatic spinal cord compression; radiotherapy; randomized trial; subgroup analyses; survival prognosis; treatment outcomes.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Dose Fractionation, Radiation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neoplasms / complications
  • Neoplasms / pathology
  • Neoplasms / radiotherapy*
  • Prognosis
  • Retrospective Studies
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / radiotherapy*
  • Spinal Neoplasms / radiotherapy*
  • Spinal Neoplasms / secondary
  • Survival Rate