Re-irradiation of spinal cord compression due to metastasis in elderly patients.
OBJECTIVE
The present study investigated efficacy and toxicity of re-irradiation for an in-field recurrence of spinal cord compression due to metastasis (SCCM) in elderly patients.


METHODS
Data of 60 patients aged ≥65 years who were irradiated for an in-field recurrence of SCCM were retrospectively analyzed. The fractionation regimen of re-irradiation and eight additional potential prognostic factors were evaluated for motor function.


RESULTS
Median time to in-field recurrence was 6 (2-45) months. After re-irradiation, 25 patients (42%) showed improvement of motor function, 28 (47%) no change, and 7 (12%) deterioration. No second in-field recurrences were observed. Post-treatment motor function was not associated with the fractionation regimen. Radiation myelopathy was not observed. The cumulative biologically-effective dose for myelopathy was 80-137 Gy2.


CONCLUSIONS
Re-irradiation for in-field recurrences of SCCM in elderly patients appears safe and effective. Myelopathy appears unlikely, if the cumulative biologically effective dose is 137 Gy2 or less. The fractionation regimen had no significant impact on motor function.
Department of Radiation Oncology, University of Lübeck, Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany. Rades.Dirk@gmx.net.
Dirk
D
Rades
Jasmin N
JN
Evers
Amira
A
Bajrovic
Theo
T
Veninga
Steven E
SE
Schild
D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary
Spinal cord compression from metastatic cancer; elderly patients; fractionation regimen; in-field recurrence; re-irradiation