ICORG 05-03: Prospective Randomized Non-Inferiority Phase 3 Trial Comparing Two Radiation Schedules in Malignant Spinal Cord Compression not Proceeding with Surgical Decompression

(ICORG 05-03): prospective randomized non-inferiority phase III trial comparing two radiation schedules in malignant spinal cord compression (not proceeding with surgical decompression); the quality of life analysis

“…None of the studies in their review reported on satisfaction with care or QoL. Since the abstract of ICORG 05-03 was presented at ASTRO 2014 [14], another two RCTs of radiotherapy schedules have been published. Both SCORE-2 and the SCORAD III compared a multifractionated schedule with fewer or single fraction and found no difference in primary end-point [20,21].…”

“…The primary outcome data was presented at the American Society for Radiation Oncology (ASTRO) 2014 meeting and showed non-inferiority [14]. An article dealing with the primary endpoint is under consideration for publication at present.…”

Assessment of National Practice for Palliative Radiation Therapy for Bone Metastases Suggests Marked Underutilization of Single-Fraction Regimens in the United States

“…However, sensitivity analyses including these patients revealed findings similar to those from our primary analyses. This information is of importance, given the evolving data regarding the use of SF-RT for cord compression (47,48). We also could not exclude the potential that a subset of our sample had complicated metastases, including impending or existing fracture.…”

Predictive Factors and a Survival Score for Patients Irradiated for Metastatic Spinal Cord Compression from Carcinoma of the Salivary Glands

“…No patient of the 0-1 point group survived 6 months or longer, and the median survival time was only 4 months. Therefore, these patients should receive a short radiation program such as 1×8 Gy or 5×4 Gy in 1 week to avoid spending more of their remaining lifetime receiving treatment than necessary (2)(3)(4)(5)(6)(7)(8). In the group with 2-3 points, all patients lived for 6 months or longer (median survival time >8 months, not yet reached).…”

“…In addition, shorter-course programs such as 5×4 Gy given over 1 week are widely used. Taking into account the available data from both prospective and large retrospective studies, patients with a poor survival prognosis should be treated with singlefraction or shorter-course radiation programs, whereas those patients with a more favorable survival prognosis can benefit from longer-lasting programs in terms of better local control and survival and less late treatment-related morbidity (4)(5)(6)(7)(8). Therefore, studies aiming to identify prognostic factors and to develop survival scores have been performed for patients with MSCC in general and for patients with MSCC from specific tumor entities (9)(10)(11)(12)(13)(14)(15)(16).…”