预测接受转移性脊髓压迫放疗患者治疗后门诊状态的评分

A score predicting posttreatment ambulatory status in patients irradiated for metastatic spinal cord compression.

作者信息

Rades Dirk, Rudat Volker, Veninga Theo, Stalpers Lukas J A, Basic Hiba, Karstens Johann H, Hoskin Peter J, Schild Steven E

机构信息

Department of Radiation Oncology, University Hospital Schleswig-Holstein, Luebeck, Germany.

出版信息

Int J Radiat Oncol Biol Phys. 2008 Nov 1;72(3):905-8. doi: 10.1016/j.ijrobp.2008.02.018. Epub 2008 Apr 23.

DOI:10.1016/j.ijrobp.2008.02.018

PMID:18436390

Abstract

PURPOSE

To create a scoring system to predict ambulatory status after radiotherapy (RT) for metastatic spinal cord compression (MSCC).

METHODS AND MATERIALS

On the basis of a multivariate analysis of 2096 MSCC patients, a scoring system was developed. This included the five prognostic factors significantly associated with post-RT ambulatory status: primary tumor type, interval between tumor diagnosis and MSCC, visceral metastases, motor function before RT, and time developing motor deficits before RT. The score for each factor was determined by dividing the post-RT ambulatory rate (as a percentage) by 10. Total scores represented the sum of the scores for each factor and ranged between 21 and 44 points. Patients were divided into five groups according to this score.

RESULTS

The post-RT ambulatory rates were 6% (24 of 389) for patients with scores of </=28 points, 44% (121 of 278) for those with 29-31 points, 70% (212 of 303) for those with 32-34 points, 86% (315 of 266) for those with 35-37 points, and 99% (750 of 760) for those with >/=38 points. The 3-month survival rates were 29%, 62%, 77%, 84%, and 98%, respectively. The 6-months survival rates were 6%, 31%, 42%, 61%, and 93%, respectively.

CONCLUSIONS

Because patients with scores of </=28 points had poor functional outcome after RT and extraordinarily poor survival rates, short-course RT to decrease pain or best supportive care may be considered. Patients with scores of 29-37 points should be considered surgical candidates, because RT-alone results were not optimal. Patients with scores of >/=38 points seem to have excellent results with RT alone.

摘要

目的

创建一种评分系统，以预测转移性脊髓压迫症（MSCC）放疗（RT）后的活动状态。

方法与材料

基于对2096例MSCC患者的多因素分析，开发了一种评分系统。这包括与放疗后活动状态显著相关的五个预后因素：原发肿瘤类型、肿瘤诊断与MSCC之间的间隔、内脏转移、放疗前的运动功能以及放疗前出现运动功能障碍的时间。每个因素的得分通过将放疗后活动率（以百分比表示）除以10来确定。总分代表每个因素得分的总和，范围在21至44分之间。根据该评分将患者分为五组。

结果

得分≤28分的患者放疗后活动率为6%（389例中的24例），29 - 31分的患者为44%（278例中的121例），32 - 34分的患者为70%（303例中的212例），35 - 37分的患者为86%（266例中的315例），得分≥38分的患者为99%（760例中的750例）。3个月生存率分别为29%、62%、77%、84%和98%。6个月生存率分别为6%、31%、42%、61%和93%。