Do bladder cancer patients with metastatic spinal cord compression benefit from radiotherapy alone?
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Do bladder cancer patients with metastatic spinal cord compression benefit from radiotherapy alone? / Rades, Dirk; Walz, Jochen; Schild, Steven E; Veninga, Theo; Dunst, Juergen.
in: UROLOGY, Jahrgang 69, Nr. 6, 6, 2007, S. 1081-1085.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Do bladder cancer patients with metastatic spinal cord compression benefit from radiotherapy alone?
AU - Rades, Dirk
AU - Walz, Jochen
AU - Schild, Steven E
AU - Veninga, Theo
AU - Dunst, Juergen
PY - 2007
Y1 - 2007
N2 - OBJECTIVES: To investigate the role of radiotherapy (RT) alone in metastatic spinal cord compression (MSCC) patients with bladder cancer. METHODS: Thirty-two MSSC patients with bladder cancer were included in this retrospective review. Potential prognostic factors were investigated for functional outcome, local control of MSCC, and survival: age, gender, performance status, visceral metastases at the time of RT, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT, and radiation schedule (short-course RT [1 week or less] versus long-course RT [2 to 4 weeks]). RESULTS: Two patients (6%) showed improvement of motor function, 25 (78%) no change, and 5 (16%) deterioration. Better functional outcome was significantly associated with a better performance status (P = 0.035). A trend was observed for absence of visceral metastases (P = 0.054). Five patients developed a recurrence of MSCC in the preirradiated spinal region, which was treated with reirradiation (0 improvement, 4 no change, 1 deterioration). Median survival was 4 months. The 1-year survival rate was only 16%. Better survival was associated with absence of visceral metastases, being ambulatory, involvement of only one to three vertebrae, and better performance status. CONCLUSIONS: Improvement of motor function was rare. For patients not suitable for decompressive surgery, short-course RT seems preferable because it provides a functional outcome similar to that with long-course RT and is more patient convenient. If the patient's prognosis seems extremely poor in terms of functional outcome and survival, single-fraction RT or even best supportive care may be considered.
AB - OBJECTIVES: To investigate the role of radiotherapy (RT) alone in metastatic spinal cord compression (MSCC) patients with bladder cancer. METHODS: Thirty-two MSSC patients with bladder cancer were included in this retrospective review. Potential prognostic factors were investigated for functional outcome, local control of MSCC, and survival: age, gender, performance status, visceral metastases at the time of RT, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT, and radiation schedule (short-course RT [1 week or less] versus long-course RT [2 to 4 weeks]). RESULTS: Two patients (6%) showed improvement of motor function, 25 (78%) no change, and 5 (16%) deterioration. Better functional outcome was significantly associated with a better performance status (P = 0.035). A trend was observed for absence of visceral metastases (P = 0.054). Five patients developed a recurrence of MSCC in the preirradiated spinal region, which was treated with reirradiation (0 improvement, 4 no change, 1 deterioration). Median survival was 4 months. The 1-year survival rate was only 16%. Better survival was associated with absence of visceral metastases, being ambulatory, involvement of only one to three vertebrae, and better performance status. CONCLUSIONS: Improvement of motor function was rare. For patients not suitable for decompressive surgery, short-course RT seems preferable because it provides a functional outcome similar to that with long-course RT and is more patient convenient. If the patient's prognosis seems extremely poor in terms of functional outcome and survival, single-fraction RT or even best supportive care may be considered.
M3 - SCORING: Zeitschriftenaufsatz
VL - 69
SP - 1081
EP - 1085
JO - UROLOGY
JF - UROLOGY
SN - 0090-4295
IS - 6
M1 - 6
ER -