Radiotherapy With 4 Gy × 5 Versus 3 Gy × 10 for Metastatic Epidural Spinal Cord Compression: Final Results of the SCORE-2 Trial (ARO 2009/01)

Abstract

Short-course RT with 4 Gy × 5 was not significantly inferior to 3 Gy × 10 in patients with MESCC and poor to intermediate expected survival.

Predictive Factors and a Survival Score for Patients Irradiated for Metastatic Spinal Cord Compression from Carcinoma of the Salivary Glands

“…In the present study, improvement of motor deficits by radiation was associated with the dynamic of the development of motor deficits prior to the start of treatment. A slower development was associated with a better functional outcome, which has been described before in other series of patients with MSCC (3,5,25). These results can be explained by the fact that a slower compression of the spinal cord mostly affects the veins and is reversible after radiation.…”

“…No patient of the 0-1 point group survived 6 months or longer, and the median survival time was only 4 months. Therefore, these patients should receive a short radiation program such as 1×8 Gy or 5×4 Gy in 1 week to avoid spending more of their remaining lifetime receiving treatment than necessary (2)(3)(4)(5)(6)(7)(8). In the group with 2-3 points, all patients lived for 6 months or longer (median survival time >8 months, not yet reached).…”

“…In addition, shorter-course programs such as 5×4 Gy given over 1 week are widely used. Taking into account the available data from both prospective and large retrospective studies, patients with a poor survival prognosis should be treated with singlefraction or shorter-course radiation programs, whereas those patients with a more favorable survival prognosis can benefit from longer-lasting programs in terms of better local control and survival and less late treatment-related morbidity (4)(5)(6)(7)(8). Therefore, studies aiming to identify prognostic factors and to develop survival scores have been performed for patients with MSCC in general and for patients with MSCC from specific tumor entities (9)(10)(11)(12)(13)(14)(15)(16).…”

A Survival Score for Patients Assigned to Palliative Radiotherapy for Metastatic Bladder Cancer

“…Several studies of palliative radiotherapy for metastases from solid tumors including bladder cancer have shown that a significant relief of symptoms can be achieved also with short radiotherapy programs that last only one day or one week. This has for example been demonstrated already for irradiation of painful bone metastases, metastatic spinal cord compression and brain metastases (2,3,(14)(15)(16)(17).…”

Practice patterns of palliative radiation therapy in pediatric oncology patients in an international pediatric research consortium

“…The heterogeneity of treatment regimens used highlights the lack of consensus for optimal palliative management in pediatrics. Whereas the safety and efficacy of a variety of dose and fractionations schedules are reported for palliative RT scenarios in adult patients, including brain metastases, bone metastases, and spinal cord compression, only few retrospective studies exist to describe the clinical experience of palliative RT in the pediatric population. Of these published retrospective studies, each report favorable rates of symptom improvement with palliative RT in pediatric patients.…”