Department of Oncology, Ipswich Hospital NHS Trust, Ipswich, UK.
Clin Oncol (R Coll Radiol). 2010 Apr;22(3):222-30. doi: 10.1016/j.clon.2010.01.006. Epub 2010 Feb 6.
Metastatic spinal cord compression is a frequent medical emergency, and the most common treatment offered is radiotherapy. The routine treatment prescription for spinal cord compression in the UK is 20 Gy in five daily fractions delivered over 1 week. Here, we evaluate the evidence base for the radiotherapy dose for spinal cord compression. Evidence from the four prospective studies conducted so far and retrospective studies does not support a uniform dose of 20 Gy for all patients with spinal cord compression. Available evidence suggests that the radiotherapy dose should be tailored to the individual patient, depending on the subtype of the tumour, the extent of metastatic disease and expected survival. A risk stratification for the optimum dose prescription for patients with spinal cord compression is recommended.
转移性脊髓压迫是一种常见的医疗急症，最常采用的治疗方法是放射治疗。在英国，常规的脊髓压迫放射治疗方案是每周 5 天，每天 1 次，共 5 次，剂量为 20Gy。在此，我们对脊髓压迫放射治疗剂量的循证医学证据进行评估。目前已开展的四项前瞻性研究和回顾性研究的证据并不支持对所有脊髓压迫患者均采用 20Gy 的统一剂量。现有证据表明，应根据肿瘤的亚型、转移疾病的程度和预期生存时间，对每位患者进行个体化的放射治疗剂量。建议对脊髓压迫患者进行最佳剂量方案的风险分层。
