Department of Radiation Oncology, University of Lübeck, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Strahlenther Onkol. 2014 Mar;190(3):283-6. doi: 10.1007/s00066-013-0473-4. Epub 2013 Nov 23.
The goal of the present work was to investigate the predictive value of the number of extraspinal organs involved by metastases for the survival of patients with metastatic spinal cord compression (MSCC) from breast cancer.
Data of 145 breast cancer patients who received 10 fractions of 3 Gy of radiotherapy (RT) alone for MSCC were retrospectively analyzed. Seven potential prognostic factors were investigated including age, Eastern Cooperative Oncology Group (ECOG) performance score, number of involved vertebrae, interval from breast cancer diagnosis to RT of MSCC, ambulatory status prior to RT, time to developing motor deficits, and the number of involved extraspinal organs.
The 1-year survival rates for involvement of 0, 1, 2, and ≥ 3 extraspinal organs were 86, 73, 36, and 16 % (p < 0.001). In the multivariate analysis, the number of involved extraspinal organs remained significant (risk ratio 2.19; 95 % confidence interval 1.61-3.00; p < 0.001). ECOG performance score (p < 0.001), ambulatory status prior to RT (p = 0.003), and the time to developing motor deficits (p < 0.001) were also significantly associated with survival in the multivariate analysis.
The number of extraspinal organs involved by metastases is an independent prognostic factor of survival in patients with MSCC from breast cancer.
本研究旨在探讨转移性脊柱脊髓压迫症（MSCC）患者转移灶累及的脊柱外器官数量对其生存的预测价值。
回顾性分析了 145 例接受单纯 10 次 3Gy 放疗（RT）治疗 MSCC 的乳腺癌患者的数据。共研究了 7 个潜在的预后因素，包括年龄、东部肿瘤协作组（ECOG）体能状态评分、受累椎体数、乳腺癌诊断至 MSCC RT 时间、RT 前的活动状态、出现运动功能障碍的时间以及累及的脊柱外器官数。
0、1、2 和≥3 个脊柱外器官受累的患者 1 年生存率分别为 86%、73%、36%和 16%（p<0.001）。多因素分析显示，累及的脊柱外器官数量仍然具有显著意义（风险比 2.19；95%置信区间 1.61-3.00；p<0.001）。ECOG 体能状态评分（p<0.001）、RT 前的活动状态（p=0.003）和出现运动功能障碍的时间（p<0.001）在多因素分析中也与生存显著相关。
转移灶累及的脊柱外器官数量是乳腺癌 MSCC 患者生存的独立预后因素。
