Re-irradiation of spinal cord compression due to metastasis in elderly patients

Background/Aim: The present study investigated efficacy and toxicity of re-irradiation for an in-field recurrence of spinal cord compression due to metastasis (SCCM) in elderly patients. Patients and Methods: Data of 60 patients aged?65 years who were irradiated for an infield recurrence of SCCM were retrospectively analyzed. The fractionation regimen of re-irradiation and eight additional potential prognostic factors were evaluated for motor function. Results: Median time to in-field recurrence was 6 (2-45) months. After re-irradiation, 25 patients (42%) showed improvement of motor function, 28 (47%) no change, and 7 (12%) deterioration. No second in-field recurrences were observed. Post-treatment motor function was not associated with the fractionation regimen. Radiation myelopathy was not observed. The cumulative biologicallyeffective dose for myelopathy was 80-137 Gy2. Conclusion: Re-irradiation for in-field recurrences of SCCM in elderly patients appears safe and effective. Myelopathy appears unlikely, if the cumulative biologically effective dose is 137 Gy 2 or less. The fractionation regimen had no significant impact on motor function.