title: A validated survival score for breast cancer patients with metastatic spinal cord compression.
abstract: BACKGROUND
  To create a validated scoring system predicting survival of breast cancer patients with metastatic spinal cord compression (MSCC).
  
  
  METHODS
  Of 510 patients, one half were assigned to either the test or the validation group. In the test group, eight pretreatment factors (age, performance status, number of involved vertebrae, ambulatory status, other bone metastases, visceral metastases, interval from cancer diagnosis to radiotherapy of MSCC, time of developing motor deficits) plus the radiation regimen were retrospectively investigated. Factors significantly associated with survival in the multivariate analysis were included in the scoring system. The score for each factor was determined by dividing the 6-month survival rate (%) by ten. The total score was the sum of the scores for each factor.
  
  
  RESULTS
  In the multivariate analysis of the test group, performance status, ambulatory status, other bone metastases, visceral metastases, interval from cancer diagnosis to radiotherapy of MSCC, and time of developing motor deficits were significant for survival and included in the score. Total scores ranged from 30 to 50 points. In the test group, the 6-month survival rates were 12% for 30-35 points, 41% for 36-40 points, 74% for 41-45 points, and 98% for 46-50 points (p < 0.0001). In the validation group, the 6-month survival rates were 14%, 46%, 77%, and 99%, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  The survival rates of the validation group were similar to the test group. Therefore, this score was reproducible and can help when selecting the appropriate radiotherapy regimen for each patient taking into account her survival prognosis.
authors.affiliation: Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. Rades.Dirk@gmx.net
authors.forename: D
authors.initials: D
authors.lastname: Rades
authors.forename: S
authors.initials: S
authors.lastname: Douglas
authors.forename: S E
authors.initials: SE
authors.lastname: Schild
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D051346:Mobility Limitation; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012107:Research Design; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones