Department of Radiation Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, 23538, Ratzeburger Allee 160, Lübeck, Germany,
Strahlenther Onkol. 2014 Jul;190(7):667-70. doi: 10.1007/s00066-014-0616-2. Epub 2014 Feb 18.
This study aimed to identify a potential association of the number of involved extraspinal organs with the survival of patients with metastatic spinal cord compression (MSCC) from renal cell carcinoma.
Data of 69 patients irradiated for MSCC from renal cell carcinoma were retrospectively evaluated for survival. The prognostic value of the number of involved extraspinal organs and eight additional factors were investigated. These additional factors included age, gender, performance status, number of involved vertebrae, interval from cancer diagnosis to radiotherapy (RT) of MSCC, ambulatory status prior to RT, time developing motor deficits, and the fractionation regimen (30 Gy in 10 fractions vs. higher doses).
The 6-month survival rates for involvement of 0, 1, and ≥ 2 extraspinal organs were 93, 57, and 21%, respectively (p < 0.001). In the multivariate analysis, the number of involved extraspinal organs maintained significance (risk ratio 2.65; 95% confidence interval 1.64-4.52; p < 0.001). The interval from cancer diagnosis to RT of MSCC (p = 0.013) and ambulatory status prior to RT (p = 0.002) were also independent predictors of survival.
The number of involved extraspinal organs is a new prognostic factor of survival in patients with MSCC from renal cell carcinoma and should be considered in future clinical trials.
本研究旨在确定涉及的脊柱外器官数量与转移性脊髓压迫症（MSCC）患者生存的潜在相关性，这些患者的肿瘤来源于肾细胞癌。
回顾性评估了 69 例接受 MSCC 放疗的肾细胞癌患者的生存数据。研究了涉及的脊柱外器官数量和其他 8 个因素的预后价值。这些附加因素包括年龄、性别、表现状态、受累椎体数量、从癌症诊断到 MSCC 放疗的时间间隔、放疗前的活动状态、出现运动功能障碍的时间以及分割方案（30Gy/10 次与更高剂量）。
涉及 0、1 和≥2 个脊柱外器官的患者 6 个月生存率分别为 93%、57%和 21%（p<0.001）。多因素分析显示，涉及的脊柱外器官数量具有显著意义（风险比 2.65；95%置信区间 1.64-4.52；p<0.001）。MSCC 放疗前癌症诊断到放疗的时间间隔（p=0.013）和放疗前的活动状态（p=0.002）也是生存的独立预测因素。
涉及的脊柱外器官数量是肾细胞癌 MSCC 患者生存的一个新的预后因素，应在未来的临床试验中考虑。
