Abstract
BackgroundThe aim of this retrospective study was to evaluate the stability of spinal metastases in gynecologic cancer patients (pts) on the basis of a validated scoring system after radiotherapy (RT), to define prognostic factors for stability and to calculate survival.MethodsFourty-four women with gynecologic malignancies and spinal bone metastases were treated at our department between January 2000 and January 2012. Out of those 34 were assessed regarding stability using the Taneichi score before, 3 and 6 months after RT. Additionally prognostic factors for stability, overall survival, and bone survival (time between first day of RT of bone metastases and death from any cause) were calculated.ResultsBefore RT 47% of pts were unstable and 6 months after RT 85% of pts were stable. Karnofsky performance status (KPS) >70% (p = 0.037) and no chemotherapy (ChT) (p = 0.046) prior to RT were significantly predictive for response. 5-year overall survival was 69% and 1-year bone survival was 73%.ConclusionsRT is capable of improving stability of osteolytic spinal metastases from gynecologic cancer by facilitating re-ossification in survivors. KPS may be a predictor for response. Pts who received ChT prior to RT may require additional bone supportive treatment to overcome bone remodeling imbalance. Survival in women with bone metastases from gynecologic cancer remains poor.
Highlights
RT is capable of improving stability of osteolytic spinal metastases from gynecologic cancer by facilitating re-ossification in survivors
Karnofsky performance status (KPS) may be a predictor for response
Bone metastases are a rare occurrence in gynecologic malignancies and in the majority of cases associated with a poor prognosis [1,2,3,4,5,6,7,8]
Summary
Bone metastases had to be located in the thoracic or lumbar spine. After 6 months 34 pts were alive and were, included in the statistical stability analysis; all 44 pts were included in the statistical survival analysis. Preexisting CT scans were reviewed regarding stability of the osteolytic lesions using the Taneichi score [13]. Response was defined as a change from unstable to stable after RT at 3 or 6 months. Overall survival was defined as the time between first diagnosis of malignancy until death from any cause, whereas bone survival was considered to be the time between first day of RT of bone metastases until death from any cause. Bowker’s test and kappa statistics were calculated to evaluate distribution of the Taneichi score over time. Univariate logistic regression analysis was performed to evaluate possible predictors for stability after 6 months
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