title: Radiotherapy for patients with metastases to the spinal column: a review of 603 patients at Shizuoka Cancer Center Hospital.
abstract: OBJECTIVE
  Long- and short-course radiotherapy have similar outcomes in the treatment of spinal metastases. Long-course radiotherapy is recommended for patients with good predicted survival to reduce the risk of in-field recurrence, whereas short-course radiotherapy is used for those with poor predicted survival. Therefore, prediction of prognosis and local control is required for selecting the optimal course of radiotherapy.
  
  
  METHODS
  The subjects were 603 patients with spinal metastases who received radiotherapy at the Shizuoka Cancer Center Hospital between September 2002 and February 2007. Factors associated with survival and local control were retrospectively investigated by multivariate analyses. Local recurrence was defined as regrowth within the irradiated field or exacerbation of symptoms such as pain and motor deficits.
  
  
  RESULTS
  Of the 603 patients, 555 (92%) were followed for 12 months or until death. The survival rates after 6, 12, and 24 months were 50%, 32%, and 19%, respectively, with a median survival of 6.2 months. The median survival periods after long- and short-course radiotherapy were 7.9 and 1.8 months, respectively. In multivariate analysis, primary tumor site, good performance status, absence of previous chemotherapy, absence of visceral metastasis, single bone metastasis, younger age, and nonhypercalcemia were associated with good survival. The local control rates after 6, 12, and 24 months were 91%, 79%, and 69%, respectively, and non-mass-type tumor, breast cancer, and absence of previous chemotherapy were predictors of good local control.
  
  
  CONCLUSIONS
  Identification of factors associated with good local control and survival may allow selection of an optimal radiotherapy schedule for patients with spinal metastases.
authors.affiliation: Division of Radiation Oncology, Shizuoka Cancer Center Hospital, Nagaizumi-cho, Shizuoka, Japan. mizumoto1717@hotmail.com
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizumoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Harada
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Asakura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Furutani
authors.forename: Haruko
authors.initials: H
authors.lastname: Hashii
authors.forename: Hideki
authors.initials: H
authors.lastname: Murata
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takagi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Katagiri
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Takahashi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D010146:Pain / Q000532:radiotherapy; D018579:Patient Selection; D011379:Prognosis; D011879:Radiotherapy Dosage; D019233:Retreatment; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D015996:Survival Rate; D055815:Young Adult