Prospective phase II study of integrated rehabilitative treatment in oncologic patients with neuromotor damage from vertebral metastases

Abstract

8207 Background: Breast, lung and prostate cancer are associated with a high incidence of bone and osteomedullar metastases, often responsible of a neuromotor damage. A prospective study was designed to verify the feasibility and activity of an integrated rehabilitative protocol in pts with neuromotor damage from vertebral metastases. Methods: Treatment was performed throughout the following steps, with short-term objectives: 1) passive stretching of lower limbs; 2) lower limb physiokinesitherapy (PKT); 3) respiratory PKT; 4) neuromotor PKT; 5) overlesional strengthen; 6) ambulatory training to the use of prescribed aids. All pts underwent dependence evaluation by the Barthel index and Quality of Life (QoL) assessment by FACT-G. Results: Forty-five consecutive pts were enrolled and treated: 26 males and 19 females, median age 20 to 79 years (20–40 years: 13 pts; 41–59 years 24 pts; 60–79 years: 8 pts). Primary tumor was breast carcinoma in 21 pts (47%), lung cancer in 12 pts (27%), prostate carcinoma in 8 pts (18%), ependyma, testis, non-Hodgkin lymphoma and multiple myeloma in each one of the remaining 4 pts. Most pts (82%) had received combined chemo-radiotherapy; while radiotherapy and chemotherapy alone were given in 6 and 3 pts, respectively. All the enrolled pts completed the integrated protocol and were valuable for tolerance and response. Treatment compliance was good, with no drop-out; improvement of QoL was observed in 93% of pts (43/45) by FACT-G. At a median follow-up of 12 months (range 6–18) the dependence evaluation according to the Barthel index showed an improvement compared to the basal levels: from total to severe in 31/45 pts (69%), from severe to moderate in 9 (20%), from moderate dependence to autonomy in 5 (11%). Conclusions: Our results show that such an integrated rehabilitative program in metastatic pts with neuromotor damage from vertebral metastases produced a good clinical activity in both preventing the damages following neurological deficit and optimizing the residual motor potentialities, also improving patient QoL throughout the achievement of the best possible autonomy. No significant financial relationships to disclose.