Re-irradiation of spinal cord compression due to metastasis in elderly patients

BACKGROUND/AIM: The present study investigated efficacy and toxicity of re-irradiation for an in-field recurrence of spinal cord compression due to metastasis (SCCM) in elderly patients.

PATIENTS AND METHODS: Data of 60 patients aged ≥65 years who were irradiated for an in-field recurrence of SCCM were retrospectively analyzed. The fractionation regimen of re-irradiation and eight additional potential prognostic factors were evaluated for motor function.

RESULTS: Median time to in-field recurrence was 6 (2-45) months. After re-irradiation, 25 patients (42%) showed improvement of motor function, 28 (47%) no change, and 7 (12%) deterioration. No second in-field recurrences were observed. Post-treatment motor function was not associated with the fractionation regimen. Radiation myelopathy was not observed. The cumulative biologically-effective dose for myelopathy was 80-137 Gy2.

CONCLUSION: Re-irradiation for in-field recurrences of SCCM in elderly patients appears safe and effective. Myelopathy appears unlikely, if the cumulative biologically effective dose is 137 Gy2 or less. The fractionation regimen had no significant impact on motor function.