Personalized Radiotherapeutic Approaches for Elderly Patients with Epidural Cord Compression from Gastric Cancer

AIM: To facilitate personalization of radiotherapy (RT) for elderly patients with epidural cord compression (ECC) from gastric cancer.

PATIENTS AND METHODS: Several factors were analyzed for survival in 20 elderly patients including age, gender, time period from gastric cancer diagnosis to ECC, metastatic spread, additional osseous lesions, vertebral bodies afflicted by ECC, ambulatory function, dynamic of motor dysfunction, performance status and RT fractionation.

RESULTS: Four factors had a significant influence on survival: metastatic spread (p<0.001), ambulatory function (p=0.001), dynamics of motor dysfunction (p=0.002) and performance status (p=0.003). Points were assigned according to factors present for each patient. To avoid confounding variables, performance status was not incorporated into the scoring system. Based on 3-month survival rates, patients were divided into four groups according to the total score: 6, 12-13, 19 and 26 points. Three-month survival rates for these groups were 0%, 50%, 75% and 100%, respectively (p<0.001).

CONCLUSION: This score is of great assistance when assigning the appropriate RT approach to an elderly patient with ECC from gastric cancer.