Excellent outcomes after radiotherapy alone for malignant spinal cord compression from myeloma

  • Dirk Rades Department of Radiation Oncology University of Lübeck
  • Antonio J Conde-Moreno Consorcio Hospital Provincial de Castellón
  • Jon Cacicedo Cruces University Hospital, Barakaldo, Vizcaya
  • Barbara Segedin Institute of Oncology Ljubljana
  • Volker Rudat Saad Specialist Hospital Al Khobar
  • Steven E Schild Mayo Clinic Scottsdale, Arizona

Abstract

Background: Uncertainty exists whether patients with spinal cord compression (SCC) from a highly radiosensitive tumor require decompressive spinal surgery in addition to radiotherapy (RT). This study addressed the question by evaluating patients receiving RT alone for SCC from myeloma.  Methods: Data of 238 patients were retrospectively analyzed for response to RT and local control of SCC. In addition, the effect of RT on motor function (improvement, no further progression, deterioration) was evaluated. Overall response was defined as improvement or no further progression of motor dysfunction. Results: In the entire cohort, the overall response rate was 97% (53% improvement plus 44% no further progression). Following RT, 88% of the patients were able to walk. Of the 69 non-ambulatory patients 44 patients (64%) regained the ability to walk. Local control rates at 1, 2 and 3 years were 93%, 82% and 82%, respectively. A trend towards better local control was observed for patients who were ambulatory before starting RT (p=0.08) and those with a more favorable performance status (p=0.07). Conclusion: RT alone provided excellent response rates, functional outcomes and local control in patients with SCC from myeloma. Therefore, the vast majority of these patients might not benefit from additional surgery.

Author Biographies

Dirk Rades, Department of Radiation Oncology University of Lübeck
Antonio J Conde-Moreno, Consorcio Hospital Provincial de Castellón
Radiation Oncology
Jon Cacicedo, Cruces University Hospital, Barakaldo, Vizcaya
Radiation Oncology
Barbara Segedin, Institute of Oncology Ljubljana
Radiotherapy
Volker Rudat, Saad Specialist Hospital Al Khobar
Radiation Oncology
Steven E Schild, Mayo Clinic Scottsdale, Arizona
Radiation Oncology
Published
2016-08-30
How to Cite
Rades, D., Conde-Moreno, A. J., Cacicedo, J., Segedin, B., Rudat, V., & Schild, S. E. (2016). Excellent outcomes after radiotherapy alone for malignant spinal cord compression from myeloma. Radiology and Oncology, 50(3). Retrieved from https://radioloncol.com/index.php/ro/article/view/2512
Section
Clinical oncology