A new and simple scoring system to predict overall survival after irradiation for metastatic spinal cord compression

Clin Transl Oncol. 2020 Mar;22(3):440-444. doi: 10.1007/s12094-019-02144-5. Epub 2019 Jun 5.

Abstract

Purpose: To develop a model that predicts survival in patients irradiated for metastatic spinal cord compression (MSCC), hence assisting in the decision between a short and a long-course radiotherapy (RT) regimen.

Methods: 138 patients diagnosed with MSCC and treated with RT alone were included. Based on a multivariate analysis, a scoring system was developed. It included four prognostic variables: age, number of vertebrae, ECOG and histology. Total scores ranged between 14 and 24 points and patients were divided into two groups.

Results: The 6-month survival rate was 22% for patients with a score of 14-18 points; and 69% for patients with a score of 19-24 points (P < 0.001). The system exhibits a high specificity and positive predictive value and an appropriate discriminative ability.

Conclusions: Patients with scores between 19 and 24 points were found to survive longer, thus a long-course RT appears to be more appropriate.

Keywords: Prognosis; Radiotherapy; Spinal cord compression.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spinal Cord Compression / mortality*
  • Spinal Cord Compression / pathology
  • Spinal Cord Compression / radiotherapy*
  • Spinal Neoplasms / mortality*
  • Spinal Neoplasms / radiotherapy*
  • Spinal Neoplasms / secondary
  • Survival Rate