Pre- and post-treatment daily life function in patients with hormone resistant prostate carcinoma treated with radiotherapy for spinal cord compression.
OBJECTIVE
To identify prognostic factors and prospectively evaluate daily life function and pain experience in hormone resistant prostate cancer patients with spinal cord compression treated with radiotherapy.


METHODS
Consecutive patients treated at the Norwegian Radium Hospital from May 1996 to October 1999 participated in the study. Daily life activities were assessed at start and discontinuation of radiotherapy and 2 and 6 months thereafter using a questionnaire based on a slightly modified Barthel activity of daily living Index. The patients were followed to death. Clinical parameters (histology, extent of disease at diagnosis, time from cancer diagnosis to start of radiotherapy, time from neurological symptoms to start of radiotherapy, age, number of spinal lesions, pre-treatment function) were assessed to try to prognosticate post-treatment function.


RESULTS
Forty-nine patients were evaluable. Time from debut of neurological deficits to start of radiotherapy was median 4 days (range 1-66). Median target dose was 30 Gy (range 9-40). Overall survival from start of radiotherapy was median 3.5 months (range 0.3-36.0). In general, improvement with regard to mobility, daily life activities and sphincter control was reported after irradiation. Post-treatment the majority of patients reported pain, usually intermittent, although they used analgesics. No clinically relevant pre-treatment parameters that predicted function after radiotherapy were identified.


CONCLUSIONS
Radiotherapy may improve mobility, daily life activity and sphincter control in patients with metastatic spinal cord compression due to hormone resistant prostate cancer. Radiotherapy should therefore be considered in all patients irrespective of the neurological deficits.
Aass
Nina
N
Department of Clinical Cancer Research, The Norwegian Radium Hospital, 0310 Oslo, Norway.
Fosså
Sophie D
SD
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000502:physiology; D018931:Antineoplastic Agents, Hormonal; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000150:complications*; D011788:Quality of Life; D012648:Self Care; D013117:Spinal Cord Compression / Q000150:complications / Q000209:etiology* / Q000532:radiotherapy*; D016019:Survival Analysis; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal