Metastatic spinal cord compression: radiotherapy outcome and dose fractionation

Hoskin, Peter; Grover, Amit H; Bhana, Rajanee

doi:10.1016/s0167-8140(03)00191-9

Cited by 90 publications

(38 citation statements)

References 11 publications

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“…However, Rades et al 12 demonstrated that long-course radiotherapy was associated with improved local control of spinal metastasis. Similar results have been observed in retrospective studies 40,41 . According to the evidence evaluated, radiotherapy appears to be effective for the maintenance and restoration of ambulatory function and for back pain relief in mscc patients.…”

Section: Discussionsupporting

confidence: 91%

Treatment of Metastatic Spinal Cord Compression: cepo Review and Clinical Recommendations

L’Espérance¹,

Vincent²,

Gaudreault

et al. 2012

Current Oncology

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the Comité de l'évolution des pratiques en oncologie• long-course radiotherapy be administered to patients with inoperable spinal cord compression and good life expectancy.• decompressive surgery followed by long-course radiotherapy be offered to appropriate symptomatic mscc patients (including spinal instability, displacement of vertebral fragment); and • patients considered for surgery have a life expectancy of at least 3-6 months.

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Section: Discussionsupporting

confidence: 91%

Treatment of Metastatic Spinal Cord Compression: cepo Review and Clinical Recommendations

L’Espérance¹,

Vincent²,

Gaudreault

et al. 2012

Current Oncology

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“…The Re-RT schedule had no significant impact on motor function, which has been previously reported for both first course of RT and Re-RT of MSCC. [12][13][14][27][28][29] Therefore, in accord with data for the first course of RT, one may consider single-fraction RT or multifraction short-course RT for patients with a poor estimated survival, who will probably not benefit from longer-course RT in terms of better recalcification and local control. 1,30 Survival after Re-RT may be predicted with the help of the prognostic factors identified in this series.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

Rades

Rudat

Veninga

et al. 2008

Cancer

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Objective: We examined whether glucose transporter 1 (GLUT1) deficiency causes common idiopathic generalized epilepsies (IGEs). Methods: The IGEs are common, heritable epilepsies that usually follow complex inheritance; currently little is known about their genetic architecture. Previously considered rare, GLUT1 deficiency, due to mutations in SLC2A1, leads to failure of glucose transport across the blood–brain barrier and inadequate glucose for brain metabolism. GLUT1 deficiency was first associated with an encephalopathy and more recently found in rare dominant families with epilepsy and paroxysmal exertional dyskinesia (PED). Five hundred four probands with IGEs and 470 controls underwent SLC2A1 sequencing. Glucose transport was assayed following expression of SLC2A1 variants in Xenopus oocytes. All available relatives were phenotyped, and SLC2A1 was sequenced. Results: Functionally validated mutations in SLC2A1 were present in 7 of 504 (1.4%) probands and 0 of 470 controls. PED, undiagnosed prior to study, occurred in 1 proband and 3 of 13 relatives with mutations. The IGEs in probands and relatives were indistinguishable from typical IGE. Three cases (0.6%) had mutations of large functional effect and showed autosomal dominant inheritance or were de novo. Four (0.8%) cases had a subtle functional effect; 2 showed possible dominant inheritance, and 2 did not. These alleles leading to subtle functional impairment may contribute to complex, polygenic inheritance of IGE. Interpretation: SLC2A1 mutations contribute to approximately 1% of IGE both as a dominant gene and as a susceptibility allele in complex inheritance. Diagnosis of GLUT1 deficiency has important treatment (ketogenic diet) and genetic counseling implications. The mechanism of restricted glucose delivery differs from the current focus on IGEs as ion channel disorders. ANN NEUROL 2012;72:807–815

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“…The life expectancy of most MSCC patients is in general relatively short, depending on the type of primary tumor 10,14,20) . Many previous studies revealed that the primary tumor (histological diagnosis) was a significant prognostic variable 1,8,11,12,22) .…”

Section: Functional Outcomementioning

confidence: 99%

“…The life expectancy of most MSCC patients is quite short, with reported median survival ranging between 2 and 6 months 10,14,20) . In long-term survivors, local control of MSCC becomes important.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Survival and Ambulatory Outcome in Metastatic Spinal Tumors : Prognostic Factor Analysis

Moon

Chung

Jahng

et al. 2011

J Korean Neurosurg Soc

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Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

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Metastatic spinal cord compression: radiotherapy outcome and dose fractionation

Cited by 90 publications

References 11 publications

Treatment of Metastatic Spinal Cord Compression: cepo Review and Clinical Recommendations

Treatment of Metastatic Spinal Cord Compression: cepo Review and Clinical Recommendations

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

Postoperative Survival and Ambulatory Outcome in Metastatic Spinal Tumors : Prognostic Factor Analysis

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