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Metastatic Spinal Cord Compression: A Survival Score Particularly Developed for Elderly Prostate Cancer Patients
Dirk Rades1, Antonio J Conde-Moreno2, Jon Cacicedo3
1Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Rades.Dirk@gmx.net.
Aim:
Metastatic spinal cord compression (MSCC) is an oncological emergency. Many elderly patients cannot tolerate intensive treatment and need individual approaches accounting for a patient's remaining lifetime. The goal of the present study was to develop a survival score for elderly prostate cancer patients with MSCC.
Patients And Methods:
Nine characteristics were analyzed in 243 patients: age, performance status, interval from prostate cancer diagnosis until MSCC, affected vertebrae, ambulatory status, further bone lesions, visceral metastases, time developing motor deficits, fractionation schedule.
Results:
Pre-radiotherapy ambulatory status (p<0.001), visceral metastases (p<0.001) and time developing motor deficits (p<0.001) were significant for survival on Cox regression analysis and included in the survival score. Four groups were defined: 9-12, 13-16, 17-19 and 21-23 points. Six-month survival rates were 7%, 28%, 71% and 95%, respectively (p<0.001).
Conclusion:
The present study identified four groups with different survival probabilities that require treatment strategies with different priorities ranging from symptom control to prolongation of life.
