Department of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Strahlenther Onkol. 2012 Dec;188(12):1114-8. doi: 10.1007/s00066-012-0141-0. Epub 2012 Nov 1.
This study aimed to identify independent prognostic factors and to create a survival score for patients with metastatic spinal cord compression (MSCC) from colorectal cancer (CRC).
Data from 121 patients irradiated for MSCC from CRC were retrospectively analyzed. Eleven potential prognostic factors were investigated including tumor type, age, gender, Eastern Cooperative Oncology Group performance status score (ECOG-PS), number of involved vertebrae, ambulatory status prior to radiotherapy (RT), other bone metastases, visceral metastases, interval from cancer diagnosis to RT of MSCC, time of developing motor deficits prior to RT, and the RT schedule.
On multivariate analysis, improved motor function was significantly associated with an ECOG-PS of 1-2 (p = 0.011) and a slower development of motor deficits (p < 0.001). Improved local control was significantly associated with absence of visceral metastases (p = 0.043) and longer-course RT (p = 0.008). Improved survival was significantly associated with an ECOG-PS of 1-2 (p < 0.001), ambulatory status (p < 0.001), absence of visceral metastases (p < 0.001), and a slower development of motor deficits (p = 0.047). These four prognostic factors were included in a survival score. The score for each factor was determined by dividing the 6-month survival rate by 10. The prognostic score represented the sum of the factor scores. Four prognostic groups were designed; the 6-month survival rates were 0% for 8-12 points, 26% for 13-18 points, 62% for 20-23 points, and 100% for 24-27 points (p < 0.001).
This study identified several independent prognostic factors for treatment outcomes in patients irradiated for MSCC from CRC. The survival prognosis of these patients can be estimated with a new score.
本研究旨在确定转移性脊髓压迫症（MSCC）患者的独立预后因素，并建立一个结直肠癌（CRC）患者的生存评分。
回顾性分析了 121 例接受 MSCC 放疗的 CRC 患者的数据。研究了 11 个潜在的预后因素，包括肿瘤类型、年龄、性别、东部合作肿瘤组表现状态评分（ECOG-PS）、受累椎体数量、放疗前的活动状态、其他骨转移、内脏转移、CRC 诊断至 MSCC 放疗的时间间隔、放疗前运动功能障碍的发展时间、以及放疗方案。
多因素分析显示，运动功能改善与 ECOG-PS 为 1-2 分（p=0.011）和运动功能障碍发展较慢（p<0.001）显著相关。局部控制改善与无内脏转移（p=0.043）和长疗程放疗（p=0.008）显著相关。生存改善与 ECOG-PS 为 1-2 分（p<0.001）、活动状态（p<0.001）、无内脏转移（p<0.001）和运动功能障碍发展较慢（p=0.047）显著相关。这四个预后因素被纳入一个生存评分中。每个因素的评分通过将 6 个月生存率除以 10 来确定。预后评分代表各因素评分之和。设计了四个预后组；8-12 分的 6 个月生存率为 0%，13-18 分的 26%，20-23 分的 62%，24-27 分的 100%（p<0.001）。
本研究确定了 CRC 患者接受 MSCC 放疗后治疗结果的几个独立预后因素。这些患者的生存预后可以用一个新的评分来估计。
