Radiation therapy in metastatic compression of the spinal cord : results of 8Gy x 2 fractions
Joint Authors
al-Sawi, Wail H.
Abd al-Muttalib, Ahmad
Source
Journal of the Egyptian National Cancer Institute
Issue
Vol. 14, Issue 1 (31 Mar. 2002), pp.1-8, 8 p.
Publisher
Cairo University National Cancer Institute
Publication Date
2002-03-31
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Topics
Abstract EN
Purpose : our aim was to evaluate the clinical outcome and toxicity of a short course of radiation therapy in selected patients with metastatic spinal cord compression.
Patients and methods : between September 1997 and December 1998, 35 patients with metastatic spinal cord compression from low radio-responsive primary tumors (non-small cell lung, kidney, bladder and gastrointestinal carcinomas and soft tissue sarcomas), or more radio-responsive ones (breast and prostate carcinomas, myeloma and non-Hodgkin's lymphoma) with paresis, plegia, low performance status (PS ECOG ≥ 3) and / or short life expectancy, underwent short-course of radiation therapy ; a single fraction of 8 Gy repeated after 1 week in responders or patients with stable disease for a total of 16 Gy.
Out of 35 evaluable patients, 3 (8.6 %) underwent simple laminecto-my and radiotherapy and the other 32 received radiotherapy alone.
Median follow up was 20 months (range, 7-32).
Response was assessed according to the severity of back pain and motor function and bladder capacity before and after radiotherapy.
Results : pain relief was achieved in 82.9% of patients and motor function response rate reached 71.4 %.
Early diagnosis and therapy were very important in predicting response to radiotherapy.
All but 2 (90 %) pretreatment walking patients and all but 1 (96.4 %) with good bladder function preserved these capacities.
On the contrary, when diagnosis was late, only 46.7 % of non-ambulatory patients and 42.9 % of those with bladder dysfunction improved.
Median survival was 6 months, with a 32 % probability of survival for 1 year.
Length of survival was significantly longer in patients with the ability to walk before and / or after radiotherapy.
The survival and duration of response was significantly associated with each other with no evidence of relapse in the irradiated area.
Sickness appeared only in a few cases.
Slight esophagitis was more frequent, dysphagia for solid foods was observed in 25 % of patients irradiated thoracic vertebrae.
Late toxicity was not observed.
Conclusion : The use of a single fraction of 8 Gy repeated after 1 week for a total of 16 Gy gave a clinical outcome comparable with that expected from more protracted regimens with only slight side effects.
The use of a few large treatment fractions could be explored considering the associated advantages for the patients and radiation therapy centers often overloaded by long patient waiting lists.
American Psychological Association (APA)
al-Sawi, Wail H.& Abd al-Muttalib, Ahmad. 2002. Radiation therapy in metastatic compression of the spinal cord : results of 8Gy x 2 fractions. Journal of the Egyptian National Cancer Institute،Vol. 14, no. 1, pp.1-8.
https://search.emarefa.net/detail/BIM-66820
Modern Language Association (MLA)
al-Sawi, Wail H.& Abd al-Muttalib, Ahmad. Radiation therapy in metastatic compression of the spinal cord : results of 8Gy x 2 fractions. Journal of the Egyptian National Cancer Institute Vol. 14, no. 1 (Mar. 2002), pp.1-8.
https://search.emarefa.net/detail/BIM-66820
American Medical Association (AMA)
al-Sawi, Wail H.& Abd al-Muttalib, Ahmad. Radiation therapy in metastatic compression of the spinal cord : results of 8Gy x 2 fractions. Journal of the Egyptian National Cancer Institute. 2002. Vol. 14, no. 1, pp.1-8.
https://search.emarefa.net/detail/BIM-66820
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 7-8
Record ID
BIM-66820