转移性脊髓压迫症：一项专门为老年前列腺癌患者制定的生存评分。

Metastatic Spinal Cord Compression: A Survival Score Particularly Developed for Elderly Prostate Cancer Patients.

作者信息

Rades Dirk, Conde-Moreno Antonio J, Cacicedo Jon, Segedin Barbara, Veninga Theo, Schild Steven E

机构信息

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany

Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón, Spain.

出版信息

Anticancer Res. 2015 Nov;35(11):6189-92.

PMID:26504049

Abstract

AIM

Metastatic spinal cord compression (MSCC) is an oncological emergency. Many elderly patients cannot tolerate intensive treatment and need individual approaches accounting for a patient's remaining lifetime. The goal of the present study was to develop a survival score for elderly prostate cancer patients with MSCC.

PATIENTS AND METHODS

Nine characteristics were analyzed in 243 patients: age, performance status, interval from prostate cancer diagnosis until MSCC, affected vertebrae, ambulatory status, further bone lesions, visceral metastases, time developing motor deficits, fractionation schedule.

RESULTS

Pre-radiotherapy ambulatory status (p<0.001), visceral metastases (p<0.001) and time developing motor deficits (p<0.001) were significant for survival on Cox regression analysis and included in the survival score. Four groups were defined: 9-12, 13-16, 17-19 and 21-23 points. Six-month survival rates were 7%, 28%, 71% and 95%, respectively (p<0.001).

CONCLUSION

The present study identified four groups with different survival probabilities that require treatment strategies with different priorities ranging from symptom control to prolongation of life.

摘要

目的

转移性脊髓压迫症（MSCC）是一种肿瘤急症。许多老年患者无法耐受强化治疗，需要根据患者的剩余寿命采取个体化方法。本研究的目的是为老年前列腺癌合并MSCC患者制定一个生存评分。

患者与方法

对243例患者的九个特征进行了分析：年龄、体能状态、从前列腺癌诊断到发生MSCC的时间间隔、受累椎体、行走状态、其他骨病变、内脏转移、出现运动功能障碍的时间、分割方案。

结果

放疗前行走状态（p<0.001）、内脏转移（p<0.001）和出现运动功能障碍的时间（p<0.001）在Cox回归分析中对生存具有显著意义，并被纳入生存评分。定义了四组：9 - 12分、13 - 16分、17 - 19分和21 - 23分。六个月生存率分别为7%、28%、71%和95%（p<0.001）。