Short-Course Radiotherapy (RT) for Metastatic Spinal Cord Compression (MSCC) Due to Renal Cell Carcinoma: Results of a Retrospective Multi-Center Study

Dirk Rades*, Jochen Walz, Lukas J.A. Stalpers, Theo Veninga, Rainer Schulte, Nermina Obralic, Ingeborg Wildfang, Rita Engenhart-Cabilic, Peter J. Hoskin, Steven E. Schild

*Corresponding author for this work
20 Citations (Scopus)

Abstract

Objective: For MSCC treatment, a short treatment time is desirable, especially if survival prognosis is poor. Survival depends on the primary tumor, extent of disease, performance status, ambulatory status, and the number of involved vertebrae. These factors may help to define the appropriate regimen for the individual patient. Our study compares short-course (1 × 8 Gy, 5 × 4 Gy) and long-course RT (10 × 3 Gy, 15 × 2.5 Gy, 20 × 2 Gy) for functional outcome in MSCC patients with renal cell carcinoma. Methods: The following potential prognostic factors for functional outcome were retrospectively investigated: age, performance status, involved vertebra, ambulatory status, time of developing motor deficits before RT, radiation schedule (short-course RT, n = 37; long-course RT, n = 50). Results: Eighty-seven patients were included in this retrospective study, 25 patients (29%) showed improvement of motor function, 52 patients (60%) no change, 10 patients (11%) deterioration. 25% of non-ambulatory patients became ambulatory after RT. Functional outcome was affected by the time of developing motor deficits before RT (p < 0.001). The RT schedule had no significant impact (p = 0.91). In the short-course RT sub-group, functional outcome was similar for 1 × 8 Gy and 5 × 4 Gy (p = 0.99). Conclusion: Short-course and long-course RT appear similarly active for MSCC in patients with renal cell carcinoma. Short-course RT appears preferable, as it is means less patient discomfort. Because 1 × 8 Gy and 5 × 4 Gy were comparably effective, 1 × 8 Gy may be suggested the best actual choice.

Original languageEnglish
JournalEuropean Urology
Volume49
Issue number5
Pages (from-to)846-852
Number of pages7
ISSN0302-2838
DOIs
Publication statusPublished - 05.2006

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