title: Radiation Therapy without Surgery for Spinal Metastases: Clinical Outcome and Prognostic Factors Analysis for Pain Control.
abstract: The purpose of radiation therapy (RT) for patients with spinal metastases is pain relief and control of paralysis. The aim of the present study was to assess pain relief using RT and to evaluate prognostic factors for pain control. We evaluated 97 consecutive patients, of mean age 62.7 years (range 28 to 86), with spinal metastases that had been treated by RT. We evaluated the effects of RT using pain level assessed using a drug grading scale based on the World Health Organization standards. The following potential prognostic factors for pain control of RT were evaluated using multivariate logistic regression analysis: age, gender, tumor type, performance status (PS), number of spinal metastases, and a history of chemotherapy. Among the 97 patients who underwent RT for pain relief, 68 patients (70.1%) presented with pain reduction. PS (odds ratio: 1.931; 95% confidence interval: 1.244 to 2.980) was revealed by multivariate logistic regression analysis to be the most important prognostic factor for pain control using RT. In conclusion, we found that RT was more effective for patients with spinal metastases while they maintained their PS.
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hoshi
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Takami
authors.affiliation: Department of Radiology, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tashiro
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
keywords: multivariate logistic regression analysis; pain relief; radiation therapy; spinal metastases