title: Neurological outcome after emergency radiotherapy in MSCC of patients with non-small cell lung cancer--a prospective trial.
abstract: BACKGROUND
  The aim of this trial was to investigate neurological outcome after emergency RT in MSCC of NSCLC patients with acute neurological deficit.
  
  
  METHODS
  This pilot trial was prospective, non-randomized, and monocentre, ten patients were treated from July 2012 until June 2013. After onset of neurological symptoms RT was started within 12 hours. The neurological outcome was assessed at baseline, and six weeks after RT using the ASIA Impairment Scale (AIS).
  
  
  RESULTS
  The results showed an improved neurological outcome in one patient (10%), one patient (10%) had a decreased, and five patients (50%) a constant outcome after six weeks. Three patients (30%) died within the first six weeks following RT, additional 4 patients (40%) died within 4 month due to tumor progression.
  
  
  CONCLUSIONS
  In this group of NSCLC patients we were able to show that emergency RT in MSCC with acute neurological deficit had no considerable benefit in neurological outcome. Therefore, short-course regime or best supportive care due to poor survival should be considered for these patients with additional distant metastases. Patients with favorable prognosis may be candidates for long-course RT.
  
  
  BACKGROUND
  Clinical trial identifier NCT 02000518.
authors.affiliation: Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. harald.rief@med.uni-heidelberg.de.
authors.forename: Harald
authors.initials: H
authors.lastname: Rief
authors.forename: Rita C
authors.initials: RC
authors.lastname: Heinhold
authors.forename: Lina C
authors.initials: LC
authors.lastname: Petersen
authors.forename: Stefan
authors.initials: S
authors.lastname: Rieken
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Arash
authors.initials: A
authors.lastname: Moghaddam-Alvandi
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Florian
authors.initials: F
authors.lastname: Sterzing
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000532:radiotherapy*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009422:Nervous System Diseases / Q000150:complications / Q000209:etiology; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome