Mutahir A Tunio, Altaf Hashmi.
Pre and post radiotherapy predictors of functional outcome and survival in metastatic spinal cord compression.
Pak J Neurological Sci Jan ;6(2):65-9.

Background: Metastatic spinal cord compression (MSCC) patients have poor prognosis, Several predictors including malignancy, duration of symptoms, performance status, other sites of bone and visceral metastases have been reported. We evaluated the pre and post radiotherapy predictors of motor dysfunction recovery and on survival in MSCC patients with urologic malignancies. Material and methods: From July 2006 to April 2009, forty seven patients were treated for MSCC. Descriptive statistics (type of malignancy, performance status, age, sex, duration of symptoms prior to radiotherapy (RT), different fractionation of RT, and other sites of metastases) were evaluated. Further multivariate analysis (Cox-proportional hazard model/Bonferroni method) was performed and Kaplan Meier survival curves were obtained using SPSS version 17.0. Results: The actuarial survival rate of study population was 55% five months, 30% at 10 months and 5% at 15 months. According to histology, overall survival rates were 13, 15, 16, and 17 months for bladder, prostate, kidney and others (germ cell and ureteric) respectively. Complete responders were 100% in ambulatory patients as compared to non ambulatory (12% complete responders) p<0.0001. Complete responders were found to have better survival (8.5 months vs. 4 months in minimal/non-responders p<0.001). However pretreatment ambulation, duration of symptoms, RT protocol, age, gender, were not found as predictors of survival. Conclusion: Urologic malignancies are considered aggressive. The ambulation and duration of symptoms at onset of RT are important prognostic factors like other malignancies at time of radiotherapy for predicting motor dysfunction recovery and survival benefit.

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