title: Personalized Radiotherapeutic Approaches for Elderly Patients with Epidural Cord Compression from Gastric Cancer.
abstract: OBJECTIVE
  To facilitate personalization of radiotherapy (RT) for elderly patients with epidural cord compression (ECC) from gastric cancer.
  
  
  METHODS
  Several factors were analyzed for survival in 20 elderly patients including age, gender, time period from gastric cancer diagnosis to ECC, metastatic spread, additional osseous lesions, vertebral bodies afflicted by ECC, ambulatory function, dynamic of motor dysfunction, performance status and RT fractionation.
  
  
  RESULTS
  Four factors had a significant influence on survival: metastatic spread (p<0.001), ambulatory function (p=0.001), dynamics of motor dysfunction (p=0.002) and performance status (p=0.003). Points were assigned according to factors present for each patient. To avoid confounding variables, performance status was not incorporated into the scoring system. Based on 3-month survival rates, patients were divided into four groups according to the total score: 6, 12-13, 19 and 26 points. Three-month survival rates for these groups were 0%, 50%, 75% and 100%, respectively (p<0.001).
  
  
  CONCLUSIONS
  This score is of great assistance when assigning the appropriate RT approach to an elderly patient with ECC from gastric cancer.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.affiliation: Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Amira
authors.initials: A
authors.lastname: Bajrovic
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Department of Hematology and Medical Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Bartscht
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D013117:Spinal Cord Compression / Q000209:etiology* / Q000532:radiotherapy*; D013274:Stomach Neoplasms / Q000150:complications*; D015996:Survival Rate
keywords: Gastric cancer; elderly patients; epidural cord compression; personalization of treatment