Role of the overall treatment time of radiotherapy with 10x3Gy for outcomes in patients with metastatic spinal cord compression
Por:
Rades D, Janssen S, Conde-Moreno AJ, Cacicedo J, Metz M, Veninga T, Segedin B, Rudat V, Schild SE
Publicada:
1 jun 2017
Resumen:
IntroductionRadiotherapy alone still is the most commonly delivered treatment modality for metastatic spinal cord compression (MSCC). MSCC is an emergency situation, which requires treatment as soon as possible. When radiotherapy is performed with the most commonly used approach 10x3Gy (30Gy in 10 fractions) over 2weeks, the question has been asked whether an overall treatment time (OTT) of 14-15days including two weekends without irradiation leads to worse outcomes than OTT of 12days (beginning of radiotherapy on a Monday resulting in only one weekend break)?
MethodsA total of 412 patients with MSCC were included in this retrospective study. Ninety-two patients receiving 10x3Gy over 12days were compared to 320 patients with an OTT of 14-15days. Ten additional factors were investigated.
ResultsOn multivariate analysis, functional outcome was associated with tumour type (P<0.001), time developing motor deficits (P<0.001), ambulatory status (P=0.018) and performance score (P<0.001); OTT had no significant impact (P=0.40). On univariate analysis of local control of MSCC (freedom from recurrence in irradiated spinal parts), no factor was significant including OTT (P=0.66). On multivariate analysis, visceral metastases (P<0.001), tumour type (P<0.001), time developing motor deficits (P<0.001), ambulatory status (P<0.001) and performance score (P<0.001) were associated with survival, OTT not even on univariate analysis (P=0.55).
ConclusionsSince an OTT of 14-15days had no negative impact on outcomes compared to 12days, compensation in form of an additional radiation fraction or continuation of radiotherapy during weekends is not required, if radiotherapy cannot be started on a Monday.
Filiaciones:
Rades D:
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Janssen S:
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany
Conde-Moreno AJ:
Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón, Spain
Cacicedo J:
Department of Radiation Oncology, Cruces University Hospital, Barakaldo, Spain
Metz M:
Department of Radiation Oncology, University of Würzburg, Würzburg, Germany
Veninga T:
Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, The Netherlands
Segedin B:
Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia
Rudat V:
Department of Radiation Oncology, Saad Specialist Hospital, Al-Khobar, Saudi Arabia
Schild SE:
Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona, USA
|