ESTRO 2024 - Abstract Book

S1932

Clinical - Mixed sites, palliation

ESTRO 2024

Purpose/Objective:

To evaluate which subgroup of spinal cord compression (SCC) is the one that least benefits from treatment and, therefore, in which it could be avoided.

We also tested our protocol to identify over-treatment in our institution.

Material/Methods:

Our protocol classifies SCC following RADES-score to choose the best therapeutic scheme and, when surgery is ruled out, stablishes RT fractionation: RADES-I single dose 8Gy, RADES-II 20Gy in 4-5 fractions, and RADES-III 30Gy in 10 fractions.

Data from SCC treated between September 2016 and January 2019 was collected. We retrospectively analyzed these data and, set 7-days survival as adequate for having benefited from at least a single RT session.

Results:

142 SCC were registered. Overall survival at 6-months was 30%. We observed that 5.6% (n=8) died before 7 days and we analyzed this subgroup:

Median age was 75y(R:50-78). All were male. 50% were lung cancer, 25% digestive neoplasms and 25% of unknown origin. All were RADES-I, and received 8Gy.

RADES-I (p=0.024), visceral disease (p=0.035) and age≥75 (p=0.007) were associated with death before one week, but these three factors were also prevalent in the >7days-survival subgroup. The combination of them (p<0.001), not prevalent in the >7days-survival subgroup, could be more useful to make a decision of discarding treatment.

Conclusion:

Our protocol does not imply over-treatment of patients, since only a small percentage would not benefit from the treatment performed. Therefore, these patients would only receive one RT session.

A combination of high-risk factors could be useful to individualize the decision to discard treatment.

Keywords: spinal cord compression, palliative radiotherapy

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