Rades Dirk, Lomidze Darejan, Jankarashvili Natalia, Lopez Campos Fernando, Navarro-Martin Arturo, Segedin Barbara, Groselj Blaz, Staackmann Christian, Yu Nathan Y, Cacicedo Jon
Department of Radiation Oncology, University of Lubeck, 23562 Lubeck, Germany.
Radiation Oncology Department, Tbilisi State Medical University, Tbilisi 0177, Georgia.
Cancers (Basel). 2024 Oct 10;16(20):3436. doi: 10.3390/cancers16203436.
Many patients with malignant spinal cord compression (MSCC) who are not candidates for neurosurgery receive radiotherapy alone. This study compared 15 × 2.633 Gy over three weeks to 20 × 2.0 Gy over four weeks in patients with favorable survival prognoses. The outcomes of 34 patients treated with 15 × 2.633 Gy (equivalent dose 41.6 Gy) in the RAMSES-01 trial were compared to 239 patients from an existing database receiving 20 × 2.0 Gy using propensity-score-adjusted Cox and logistic regression models. All patients had favorable survival prognoses. Endpoints included local progression-free survival (LPFS), improvement of motor function, post-treatment ambulatory status, and overall survival (OS). After propensity score adjustment, the 12-month rates of LPFS and OS were 98.1% (RAMSES-01 cohort) vs. 91.6% ( = 0.265) and 79.1% vs. 82.2% ( = 0.704), respectively. Regarding improvement of motor function, 15 × 2.633 Gy appeared superior ( = 0.073). No significant difference was observed regarding ambulatory status ( = 0.822). The three-week regimen for MSCC has similar outcomes and reduces treatment time when compared to a four-week regimen.
许多不适合接受神经外科手术的恶性脊髓压迫症（MSCC）患者仅接受放疗。本研究在生存预后良好的患者中，比较了三周内给予15次、每次2.633 Gy与四周内给予20次、每次2.0 Gy的放疗效果。使用倾向评分调整的Cox模型和逻辑回归模型，将RAMSES - 01试验中34例接受15次、每次2.633 Gy（等效剂量41.6 Gy）治疗的患者的结果，与来自现有数据库的239例接受20次、每次2.0 Gy治疗的患者的结果进行比较。所有患者的生存预后均良好。终点指标包括局部无进展生存期（LPFS）、运动功能改善情况、治疗后行走状态和总生存期（OS）。经过倾向评分调整后，LPFS和OS的12个月发生率分别为98.1%（RAMSES - 01队列）对91.6%（P = 0.265）和79.1%对82.2%（P = 0.704）。在运动功能改善方面，15次、每次2.633 Gy的方案似乎更具优势（P = 0.073）。在行走状态方面未观察到显著差异（P = 0.822）。与四周方案相比，MSCC的三周方案具有相似的疗效且缩短了治疗时间。
