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Prognostic factors in a series of 504 breast cancer patients with metastatic spinal cord compression
Background This study was performed to identify new significant prognostic factors in breast cancer patients irradiated for metastatic spinal cord compression (MSCC). Patients and methods The data of 504 patients with breast cancer patients with MSCC were retrospectively analyzed with respect to pos...
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| Published in: | Strahlentherapie und Onkologie 2012-04, Vol.188 (4), p.340-345 |
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| container_title | Strahlentherapie und Onkologie |
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| creator | Rades, D. Douglas, S. Veninga, T. Stalpers, L.J.A. Bajrovic, A. Rudat, V. Schild, S.E. |
| description | Background
This study was performed to identify new significant prognostic factors in breast cancer patients irradiated for metastatic spinal cord compression (MSCC).
Patients and methods
The data of 504 patients with breast cancer patients with MSCC were retrospectively analyzed with respect to posttreatment motor function, local control of MSCC, and survival. The investigated potential prognostic factors included age, Eastern Cooperative Oncology Group (ECOG) performance score, number of involved vertebrae, other bone metastases, visceral metastases, pretreatment ambulatory status, interval from cancer diagnosis to radiotherapy of MSCC, time developing motor deficits before radiotherapy, and the radiation schedule.
Results
On multivariate analysis, better functional outcome was associated with ambulatory status prior to RT (estimate − 1.29, p |
| doi_str_mv | 10.1007/s00066-011-0061-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1021639485</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2693703231</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-db425d928a27b902e689060a1619f12d53ed0f71fd4b3d3519b1e9f47aeba9153</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMotlZ_gBcJeF6dSbK7zVGKX1DQg4K3JbvJ1i3tZs2kiP_elFbx4iUTmGfeGR7GzhGuEKC8JgAoigwQs_TBTB2wMSqpM9D67ZCNAUudlZhPR-yEaAmAhdLqmI2EkLmSUo6ZfQ5-0XuKXcNb00QfiHc9N5xc6Bxx3_IcFK-DMxR5Y_rGBT6Y2Lk-Ev_s4jtfu5h6ZptAQ9ebFW98sOlZD8ERdb4_ZUetWZE729cJe727fZk9ZPOn-8fZzTxrZCliZmslcqvF1Iiy1iBcMdVQgMECdYvC5tJZaEtsraqllTnqGp1uVWlcbTTmcsIud7lD8B8bR7Fa-k1IF1GFILCQWk23FO6oJnii4NpqCN3ahK8EVVuv1c5rlbxWW6-VSjMX--RNvXb2d-JHZALEDqDU6hcu_F39X-o3ZRaC0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1021639485</pqid></control><display><type>article</type><title>Prognostic factors in a series of 504 breast cancer patients with metastatic spinal cord compression</title><source>Springer Nature</source><creator>Rades, D. ; Douglas, S. ; Veninga, T. ; Stalpers, L.J.A. ; Bajrovic, A. ; Rudat, V. ; Schild, S.E.</creator><creatorcontrib>Rades, D. ; Douglas, S. ; Veninga, T. ; Stalpers, L.J.A. ; Bajrovic, A. ; Rudat, V. ; Schild, S.E.</creatorcontrib><description>Background
This study was performed to identify new significant prognostic factors in breast cancer patients irradiated for metastatic spinal cord compression (MSCC).
Patients and methods
The data of 504 patients with breast cancer patients with MSCC were retrospectively analyzed with respect to posttreatment motor function, local control of MSCC, and survival. The investigated potential prognostic factors included age, Eastern Cooperative Oncology Group (ECOG) performance score, number of involved vertebrae, other bone metastases, visceral metastases, pretreatment ambulatory status, interval from cancer diagnosis to radiotherapy of MSCC, time developing motor deficits before radiotherapy, and the radiation schedule.
Results
On multivariate analysis, better functional outcome was associated with ambulatory status prior to RT (estimate − 1.29, p < 0.001), no visceral metastases (estimate − 0.52, p = 0.020), and slower development of motor deficits (estimate + 2.47, p < 0.001). Improved local control was significantly associated with no other bone metastases (risk ratio (RR) 4.33, 95% confidence interval (CI) 1.36–14.02, p = 0.013) and no visceral metastases (RR 3.02, 95% CI 1.42–6.40, p = 0.005). Improved survival was significantly associated with involvement of only 1–2 vertebrae (RR 1.27, 95% CI 1.01–1.60, p = 0.044), ambulatory status before radiotherapy (RR 1.75, 95% CI 1.23–2.50, p = 0.002), no other bone metastases (RR 1.93, 95% CI 1.18–3.13, p = 0.009), no visceral metastases (RR 7.60, 95% CI 5.39–10.84, p < 0.001), and time developing motor deficits before radiotherapy (RR 1.55, 95% CI 1.30–1.86, p < 0.001).
Conclusion
Several new independent prognostic factors were identified for treatment outcomes. These prognostic factors should be considered in future trials and may be used to develop prognostic scores for breast cancer patients with MSCC.</description><identifier>ISSN: 0179-7158</identifier><identifier>EISSN: 1439-099X</identifier><identifier>DOI: 10.1007/s00066-011-0061-4</identifier><identifier>PMID: 22354333</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Activities of Daily Living - classification ; Aged ; Antiemetics - administration & dosage ; Breast Neoplasms - radiotherapy ; Cohort Studies ; Dexamethasone - administration & dosage ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lumbar Vertebrae - radiation effects ; Magnetic Resonance Imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Mobility Limitation ; Multivariate Analysis ; Neoplasm Staging ; Neurologic Examination - radiation effects ; Oncology ; Original Article ; Prognosis ; Proportional Hazards Models ; Radiotherapy ; Retrospective Studies ; Spinal Cord Compression - mortality ; Spinal Cord Compression - pathology ; Spinal Cord Compression - radiotherapy ; Spinal Neoplasms - mortality ; Spinal Neoplasms - pathology ; Spinal Neoplasms - radiotherapy ; Spinal Neoplasms - secondary ; Survival Analysis ; Thoracic Vertebrae - radiation effects ; Tomography, X-Ray Computed</subject><ispartof>Strahlentherapie und Onkologie, 2012-04, Vol.188 (4), p.340-345</ispartof><rights>Urban & Vogel 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-db425d928a27b902e689060a1619f12d53ed0f71fd4b3d3519b1e9f47aeba9153</citedby><cites>FETCH-LOGICAL-c372t-db425d928a27b902e689060a1619f12d53ed0f71fd4b3d3519b1e9f47aeba9153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22354333$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rades, D.</creatorcontrib><creatorcontrib>Douglas, S.</creatorcontrib><creatorcontrib>Veninga, T.</creatorcontrib><creatorcontrib>Stalpers, L.J.A.</creatorcontrib><creatorcontrib>Bajrovic, A.</creatorcontrib><creatorcontrib>Rudat, V.</creatorcontrib><creatorcontrib>Schild, S.E.</creatorcontrib><title>Prognostic factors in a series of 504 breast cancer patients with metastatic spinal cord compression</title><title>Strahlentherapie und Onkologie</title><addtitle>Strahlenther Onkol</addtitle><addtitle>Strahlenther Onkol</addtitle><description>Background
This study was performed to identify new significant prognostic factors in breast cancer patients irradiated for metastatic spinal cord compression (MSCC).
Patients and methods
The data of 504 patients with breast cancer patients with MSCC were retrospectively analyzed with respect to posttreatment motor function, local control of MSCC, and survival. The investigated potential prognostic factors included age, Eastern Cooperative Oncology Group (ECOG) performance score, number of involved vertebrae, other bone metastases, visceral metastases, pretreatment ambulatory status, interval from cancer diagnosis to radiotherapy of MSCC, time developing motor deficits before radiotherapy, and the radiation schedule.
Results
On multivariate analysis, better functional outcome was associated with ambulatory status prior to RT (estimate − 1.29, p < 0.001), no visceral metastases (estimate − 0.52, p = 0.020), and slower development of motor deficits (estimate + 2.47, p < 0.001). Improved local control was significantly associated with no other bone metastases (risk ratio (RR) 4.33, 95% confidence interval (CI) 1.36–14.02, p = 0.013) and no visceral metastases (RR 3.02, 95% CI 1.42–6.40, p = 0.005). Improved survival was significantly associated with involvement of only 1–2 vertebrae (RR 1.27, 95% CI 1.01–1.60, p = 0.044), ambulatory status before radiotherapy (RR 1.75, 95% CI 1.23–2.50, p = 0.002), no other bone metastases (RR 1.93, 95% CI 1.18–3.13, p = 0.009), no visceral metastases (RR 7.60, 95% CI 5.39–10.84, p < 0.001), and time developing motor deficits before radiotherapy (RR 1.55, 95% CI 1.30–1.86, p < 0.001).
Conclusion
Several new independent prognostic factors were identified for treatment outcomes. These prognostic factors should be considered in future trials and may be used to develop prognostic scores for breast cancer patients with MSCC.</description><subject>Activities of Daily Living - classification</subject><subject>Aged</subject><subject>Antiemetics - administration & dosage</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Cohort Studies</subject><subject>Dexamethasone - administration & dosage</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lumbar Vertebrae - radiation effects</subject><subject>Magnetic Resonance Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mobility Limitation</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Neurologic Examination - radiation effects</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy</subject><subject>Retrospective Studies</subject><subject>Spinal Cord Compression - mortality</subject><subject>Spinal Cord Compression - pathology</subject><subject>Spinal Cord Compression - radiotherapy</subject><subject>Spinal Neoplasms - mortality</subject><subject>Spinal Neoplasms - pathology</subject><subject>Spinal Neoplasms - radiotherapy</subject><subject>Spinal Neoplasms - secondary</subject><subject>Survival Analysis</subject><subject>Thoracic Vertebrae - radiation effects</subject><subject>Tomography, X-Ray Computed</subject><issn>0179-7158</issn><issn>1439-099X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp1kE1LAzEQhoMotlZ_gBcJeF6dSbK7zVGKX1DQg4K3JbvJ1i3tZs2kiP_elFbx4iUTmGfeGR7GzhGuEKC8JgAoigwQs_TBTB2wMSqpM9D67ZCNAUudlZhPR-yEaAmAhdLqmI2EkLmSUo6ZfQ5-0XuKXcNb00QfiHc9N5xc6Bxx3_IcFK-DMxR5Y_rGBT6Y2Lk-Ev_s4jtfu5h6ZptAQ9ebFW98sOlZD8ERdb4_ZUetWZE729cJe727fZk9ZPOn-8fZzTxrZCliZmslcqvF1Iiy1iBcMdVQgMECdYvC5tJZaEtsraqllTnqGp1uVWlcbTTmcsIud7lD8B8bR7Fa-k1IF1GFILCQWk23FO6oJnii4NpqCN3ahK8EVVuv1c5rlbxWW6-VSjMX--RNvXb2d-JHZALEDqDU6hcu_F39X-o3ZRaC0w</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Rades, D.</creator><creator>Douglas, S.</creator><creator>Veninga, T.</creator><creator>Stalpers, L.J.A.</creator><creator>Bajrovic, A.</creator><creator>Rudat, V.</creator><creator>Schild, S.E.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20120401</creationdate><title>Prognostic factors in a series of 504 breast cancer patients with metastatic spinal cord compression</title><author>Rades, D. ; Douglas, S. ; Veninga, T. ; Stalpers, L.J.A. ; Bajrovic, A. ; Rudat, V. ; Schild, S.E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-db425d928a27b902e689060a1619f12d53ed0f71fd4b3d3519b1e9f47aeba9153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Activities of Daily Living - classification</topic><topic>Aged</topic><topic>Antiemetics - administration & dosage</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Cohort Studies</topic><topic>Dexamethasone - administration & dosage</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lumbar Vertebrae - radiation effects</topic><topic>Magnetic Resonance Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mobility Limitation</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Neurologic Examination - radiation effects</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy</topic><topic>Retrospective Studies</topic><topic>Spinal Cord Compression - mortality</topic><topic>Spinal Cord Compression - pathology</topic><topic>Spinal Cord Compression - radiotherapy</topic><topic>Spinal Neoplasms - mortality</topic><topic>Spinal Neoplasms - pathology</topic><topic>Spinal Neoplasms - radiotherapy</topic><topic>Spinal Neoplasms - secondary</topic><topic>Survival Analysis</topic><topic>Thoracic Vertebrae - radiation effects</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rades, D.</creatorcontrib><creatorcontrib>Douglas, S.</creatorcontrib><creatorcontrib>Veninga, T.</creatorcontrib><creatorcontrib>Stalpers, L.J.A.</creatorcontrib><creatorcontrib>Bajrovic, A.</creatorcontrib><creatorcontrib>Rudat, V.</creatorcontrib><creatorcontrib>Schild, S.E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Strahlentherapie und Onkologie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rades, D.</au><au>Douglas, S.</au><au>Veninga, T.</au><au>Stalpers, L.J.A.</au><au>Bajrovic, A.</au><au>Rudat, V.</au><au>Schild, S.E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic factors in a series of 504 breast cancer patients with metastatic spinal cord compression</atitle><jtitle>Strahlentherapie und Onkologie</jtitle><stitle>Strahlenther Onkol</stitle><addtitle>Strahlenther Onkol</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>188</volume><issue>4</issue><spage>340</spage><epage>345</epage><pages>340-345</pages><issn>0179-7158</issn><eissn>1439-099X</eissn><abstract>Background
This study was performed to identify new significant prognostic factors in breast cancer patients irradiated for metastatic spinal cord compression (MSCC).
Patients and methods
The data of 504 patients with breast cancer patients with MSCC were retrospectively analyzed with respect to posttreatment motor function, local control of MSCC, and survival. The investigated potential prognostic factors included age, Eastern Cooperative Oncology Group (ECOG) performance score, number of involved vertebrae, other bone metastases, visceral metastases, pretreatment ambulatory status, interval from cancer diagnosis to radiotherapy of MSCC, time developing motor deficits before radiotherapy, and the radiation schedule.
Results
On multivariate analysis, better functional outcome was associated with ambulatory status prior to RT (estimate − 1.29, p < 0.001), no visceral metastases (estimate − 0.52, p = 0.020), and slower development of motor deficits (estimate + 2.47, p < 0.001). Improved local control was significantly associated with no other bone metastases (risk ratio (RR) 4.33, 95% confidence interval (CI) 1.36–14.02, p = 0.013) and no visceral metastases (RR 3.02, 95% CI 1.42–6.40, p = 0.005). Improved survival was significantly associated with involvement of only 1–2 vertebrae (RR 1.27, 95% CI 1.01–1.60, p = 0.044), ambulatory status before radiotherapy (RR 1.75, 95% CI 1.23–2.50, p = 0.002), no other bone metastases (RR 1.93, 95% CI 1.18–3.13, p = 0.009), no visceral metastases (RR 7.60, 95% CI 5.39–10.84, p < 0.001), and time developing motor deficits before radiotherapy (RR 1.55, 95% CI 1.30–1.86, p < 0.001).
Conclusion
Several new independent prognostic factors were identified for treatment outcomes. These prognostic factors should be considered in future trials and may be used to develop prognostic scores for breast cancer patients with MSCC.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22354333</pmid><doi>10.1007/s00066-011-0061-4</doi><tpages>6</tpages></addata></record> |
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| subjects | Activities of Daily Living - classification Aged Antiemetics - administration & dosage Breast Neoplasms - radiotherapy Cohort Studies Dexamethasone - administration & dosage Female Follow-Up Studies Humans Kaplan-Meier Estimate Lumbar Vertebrae - radiation effects Magnetic Resonance Imaging Medicine Medicine & Public Health Middle Aged Mobility Limitation Multivariate Analysis Neoplasm Staging Neurologic Examination - radiation effects Oncology Original Article Prognosis Proportional Hazards Models Radiotherapy Retrospective Studies Spinal Cord Compression - mortality Spinal Cord Compression - pathology Spinal Cord Compression - radiotherapy Spinal Neoplasms - mortality Spinal Neoplasms - pathology Spinal Neoplasms - radiotherapy Spinal Neoplasms - secondary Survival Analysis Thoracic Vertebrae - radiation effects Tomography, X-Ray Computed |
| title | Prognostic factors in a series of 504 breast cancer patients with metastatic spinal cord compression |
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