title: Spinal bone metastases in gynecologic malignancies: a retrospective analysis of stability, prognostic factors and survival.
abstract: BACKGROUND
  The aim of this retrospective study was to evaluate the stability of spinal metastases in gynecologic cancer patients (pts) on the basis of a validated scoring system after radiotherapy (RT), to define prognostic factors for stability and to calculate survival.
  
  
  METHODS
  Fourty-four women with gynecologic malignancies and spinal bone metastases were treated at our department between January 2000 and January 2012. Out of those 34 were assessed regarding stability using the Taneichi score before, 3 and 6 months after RT. Additionally prognostic factors for stability, overall survival, and bone survival (time between first day of RT of bone metastases and death from any cause) were calculated.
  
  
  RESULTS
  Before RT 47% of pts were unstable and 6 months after RT 85% of pts were stable. Karnofsky performance status (KPS) >70% (p = 0.037) and no chemotherapy (ChT) (p = 0.046) prior to RT were significantly predictive for response. 5-year overall survival was 69% and 1-year bone survival was 73%.
  
  
  CONCLUSIONS
  RT is capable of improving stability of osteolytic spinal metastases from gynecologic cancer by facilitating re-ossification in survivors. KPS may be a predictor for response. Pts who received ChT prior to RT may require additional bone supportive treatment to overcome bone remodeling imbalance. Survival in women with bone metastases from gynecologic cancer remains poor.
authors.forename: Robert
authors.initials: R
authors.lastname: Foerster
authors.forename: Daniel
authors.initials: D
authors.lastname: Habermehl
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Tilman
authors.initials: T
authors.lastname: Bostel
authors.forename: Ingmar
authors.initials: I
authors.lastname: Schlampp
authors.forename: Thomas
authors.initials: T
authors.lastname: Welzel
authors.forename: Juergen
authors.initials: J
authors.lastname: Debus
authors.affiliation: Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. harald.rief@med.uni-heidelberg.de.
authors.forename: Harald
authors.initials: H
authors.lastname: Rief
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D055815:Young Adult