[Radiotherapy of spinal metastases in breast cancer. Apropos of a series of 108 patients].
OBJECTIVE
Retrospective analysis of analgesic, decompressive and remineralization effects of radiation therapy for spinal metastases in breast cancer.


METHODS
From January 1990 to December 1992, 108 patients with breast cancer were treated by irradiation at the Bergonié Institute for a first spinal metastasis. Three patients had undergone previous surgery (laminectomy and Doves' frame). The indication of radiation therapy was analgesic (102 patients) or decompressive (six patients). The usual irradiation scheme was 30 Gy/10 fractions/2 weeks.


RESULTS
The analgesic effect was considered as 'complete' or 'almost complete' (83%), 'moderate' (13%) or absent (4%). The mean time to the maximum analgesic response was 35 days. The duration of both the analgesic response and remineralization effects could not be retrospectively assessed due to lack of data. Decompressive effects were complete in five cases and absent in one case. A second spinal radiation therapy was necessary 78 times (eight times in junction field within 6 months following the first treatment). Spinal cord compression occurred either out of (three cases) or within (one case) the irradiated field.


CONCLUSIONS
Radiation therapy for spinal metastases in breast cancer remains a palliative analgesic treatment. Indication for decompression is rare. However, assessment of compressive 'risk' leads to discussion of radiological staging (contribution of magnetic resonance imaging) and possible previous treatment (vertebroplasty or osteosynthesis).
Prié
L
L
Institut Bergonié, centre régional de lutte contre le cancer, Bordeaux, France.
Lagarde
P
P
Palussière
J
J
el Ayoubi
S
S
Dilhuydy
J M
JM
Durand
M
M
Vital
J M
JM
Kantor
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010166:Palliative Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000532:radiotherapy; D013125:Spinal Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary*; D016019:Survival Analysis; D016896:Treatment Outcome