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• W2004706775 abstract "No AccessJournal of UrologyAdult urology1 Feb 2006Evaluation of Functional Outcome and Local Control After Radiotherapy for Metastatic Spinal Cord Compression in Patients With Prostate Cancer Dirk Rades, Lukas J.A. Stalpers, Theo Veninga, Volker Rudat, Rainer Schulte, and Peter J. Hoskin Dirk RadesDirk Rades Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg More articles by this author , Lukas J.A. StalpersLukas J.A. Stalpers Germany, Department of Radiotherapy, Academic Medical Center, Amsterdam More articles by this author , Theo VeningaTheo Veninga Department of Radiation Oncology, Dr. Bernard Verbeeten Institute, Tilburg More articles by this author , Volker RudatVolker Rudat Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg More articles by this author , Rainer SchulteRainer Schulte Department of Radiation Oncology, University Hospital Lubeck, Lubeck More articles by this author , and Peter J. HoskinPeter J. Hoskin The Netherlands, and Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00241-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Patients with prostate cancer with metastatic spinal cord compression have better survival prognosis than other patients with MSCC and may live long enough to develop a local recurrence of MSCC. This study investigates prognostic factors and radiation schedules for functional outcome and local control of MSCC after radiotherapy in patients with prostate cancer. Materials and Methods: A total of 281 patients irradiated between January 1992 and December 2003 were included. Potential prognostic factors were investigated including age, performance status, number of involved vertebra, pretreatment ambulatory status, time of developing motor deficits before RT and radiation schedule – short course RT (1×8/5×4 Gy) vs long course RT (10×3/15×2.5/20×2 Gy). Results: Overall response to RT was 86% (33% improvement of motor function, 53% no further progression). Of the nonambulatory patients 33% regained the ability to walk. On multivariate analysis functional outcome was significantly affected by the time of developing motor deficits before RT (more than 14 days better than 8 to 14 days and 1 to 7 days, p <0.001) and number of involved vertebrae (1 to 2 better than 3 or more, p = 0.013), but not by the radiation schedule (p = 0.859). The 2-year local control of MSCC was 84% depending on the radiation schedule (better after long course RT, p = 0.001). Conclusions: Functional outcome after RT was significantly influenced by the time of developing motor deficits before RT and number of involved vertebra. Local control was significantly better after application of long course RT. Patients with a poor expected survival could be treated with short course RT, because a short treatment time means less discomfort for the patient. For patients with good survival prognosis, long course RT should be applied to achieve better local control. References 1 : Always on a Friday? Time pattern of referral for spinal cord compression. Acta Oncol2001; 40: 88. Google Scholar 2 : A randomized trial of direct decompressive surgical resection in the treatment of spinal cord compression caused by metastasis. Proc Am Soc Clin Oncol2003; 22: 1. Google Scholar 3 : Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial. Int J Radiat Oncol Biol Phys1995; 32: 959. 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Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 2February 2006Page: 552-556 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsprostatic neoplasmsspinal cord compressionradiotherapyMetricsAuthor Information Dirk Rades Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg More articles by this author Lukas J.A. Stalpers Germany, Department of Radiotherapy, Academic Medical Center, Amsterdam More articles by this author Theo Veninga Department of Radiation Oncology, Dr. Bernard Verbeeten Institute, Tilburg More articles by this author Volker Rudat Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg More articles by this author Rainer Schulte Department of Radiation Oncology, University Hospital Lubeck, Lubeck More articles by this author Peter J. Hoskin The Netherlands, and Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex, United Kingdom More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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