Defining the appropriate radiotherapy regimen for metastatic spinal cord compression in non-small cell lung cancer patients.
Many different schedules are used world wide for radiotherapy (RT) of metastatic spinal cord compression (MSCC). Non-small cell lung cancer (NSCLC) patients have an extraordinarily poor survival prognosis and would benefit from a short overall treatment time. This retrospective study compares short-course RT (1 x 8 Gy/1 day, 5 x 4 Gy/1 week) and long-course RT (10 x 3 Gy/2 weeks, 15 x 2.5 Gy/3 weeks, 20 x 2 Gy/4 weeks) for functional outcome in 252 NSCLC patients developing MSCC. Improvement of motor function occurred in 14% of patients, no change in 54%, and deterioration in 32%. Functional outcome was affected by the time of developing motor deficits before RT (>14 days better than 1-7 days and 8-14 days, P<0.001), not by the radiation regimen (P=0.87). In the short-course RT group, functional outcome was similar for 1 x 8 Gy and 5 x 4 Gy (P=0.94). Short-course and long-course RT appear similarly effective for MSCC in NSCLC patients. As 1 x 8 Gy and 5 x 4 Gy showed comparable results, 1 x 8 Gy can be considered appropriate.
Department of Radiation Oncology, University Medical Center Hamburg Eppendorf, University Hospital Hamburg, Martinistr. 52, D-20246 Hamburg, Germany. Rades.Dirk@gmx.net
Dirk
D
Rades
Lukas J A
LJ
Stalpers
Rainer
R
Schulte
Theo
T
Veninga
Hiba
H
Basic
Rita
R
Engenhart-Cabilic
Steven E
SE
Schild
Peter J
PJ
Hoskin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy* / Q000556:secondary; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000532:radiotherapy*; D013120:Spinal Cord Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D016019:Survival Analysis; D016896:Treatment Outcome