8 Gy single-dose radiotherapy is effective in metastatic spinal cord compression: Results of a phase III randomized multicentre Italian trial

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• 作者：Ernesto Maranzano ; Fabio Trippa ; Michelina Casale ; Sara Costantini ; Marco Lupattelli ; Rita Bellavita ; Luigi Marafioti ; Stefano Pergolizzi ; Anna Santacaterina ; Marcello Mignogna ; Giovanni Silvano ; Vinc
• 关键词：Metastatic spinal cord compression ; Radiotherapy ; Short-course radiotherapy ; Single-dose radiotherapy
• 刊名：Radiotherapy and Oncology
• 出版年：2009
• 出版时间：November 2009
• 年：2009
• 卷：93
• 期：2
• 页码：174-179
• 全文大小：190 K

文摘

Background and purpose

In a previous randomized trial we showed that the short-course radiotherapy (RT) regimen of 8 Gy × 2 was feasible in patients with metastatic spinal cord compression (MSCC) and short life expectancy. This phase III trial was planned to determine whether in the same category of patients 8 Gy single-dose is as effective as 8 Gy × 2.

Materials and methods

Three hundred and twenty-seven patients with MSCC and short life expectancy were randomly assigned to a short-course of 8 Gy × 2 or to 8 Gy single-dose RT. Median follow-up was 31 months (range, 4–58).

Results

A total of 303 (93 % ) patients are assessable, 150 treated with the short-course and 153 with the single-dose RT. No difference in response was found between the two RT schedules adopted. Median duration of response was 5 and 4.5 months for short-course and single-dose RT (p = 0.4), respectively. The median overall survival was 4 months for all cases. Light acute toxicity was registered in a minority of cases. Late toxicity was never recorded.

Conclusions

Both RT schedules adopted were effective. As already shown in several trials evaluating RT regimens in uncomplicated painful bone metastases, also MSCC patients may achieve palliation with minimal toxicity and inconvenience with a single-dose of 8 Gy.