Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Radiat Oncol. 2013 Dec 28;8:297. doi: 10.1186/1748-717X-8-297.
The aim of this trial was to investigate neurological outcome after emergency RT in MSCC of NSCLC patients with acute neurological deficit.
This pilot trial was prospective, non-randomized, and monocentre, ten patients were treated from July 2012 until June 2013. After onset of neurological symptoms RT was started within 12 hours. The neurological outcome was assessed at baseline, and six weeks after RT using the ASIA Impairment Scale (AIS).
The results showed an improved neurological outcome in one patient (10%), one patient (10%) had a decreased, and five patients (50%) a constant outcome after six weeks. Three patients (30%) died within the first six weeks following RT, additional 4 patients (40%) died within 4 month due to tumor progression.
In this group of NSCLC patients we were able to show that emergency RT in MSCC with acute neurological deficit had no considerable benefit in neurological outcome. Therefore, short-course regime or best supportive care due to poor survival should be considered for these patients with additional distant metastases. Patients with favorable prognosis may be candidates for long-course RT.
Clinical trial identifier NCT 02000518.
本试验旨在研究伴有急性神经功能缺损的非小细胞肺癌患者发生 MSCC 后，紧急放疗对神经功能预后的影响。
本试验为前瞻性、非随机、单中心研究，共纳入 10 例 2012 年 7 月至 2013 年 6 月期间发病的伴有急性神经功能缺损的非小细胞肺癌患者。在出现神经症状后 12 小时内开始进行放疗。采用 ASIA 损伤量表（AIS）于基线和放疗后 6 周对神经功能预后进行评估。
结果显示，1 例（10%）患者的神经功能预后改善，1 例（10%）患者的神经功能预后恶化，5 例（50%）患者的神经功能预后无变化。放疗后 6 周内，3 例（30%）患者死亡，4 例（40%）患者在 4 个月内因肿瘤进展死亡。
在本研究中，我们发现伴有急性神经功能缺损的非小细胞肺癌患者接受 MSCC 紧急放疗对神经功能预后无明显获益。因此，对于伴有多发远处转移的患者，应考虑采用短程放疗或最佳支持治疗，因为这些患者的生存预后较差。对于预后较好的患者，可考虑进行长程放疗。
临床试验标识符 NCT 02000518。
