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In the multivariate analysis of this study, improved survival was associated
with better ECOG performance status, absence of visceral metastases,
ambulatory status before radiotherapy, and slower development of motor
deficits. A strong trend was observed for absence of other bone metastases.
The ECOG performance is correlated with the ambulatory status, which is known
as a significant predictor of survival. The negative impact of other bone
metastases or visceral metastases on survival has also been previously
described. A faster development of motor deficits reflects a more aggressive
disease likely to be associated with a poorer survival prognosis. Patients
treated with DDSS( direct decompressive surgery plus stabilization)
+ RT had a non-significantly better survival than the patients treated with RT alone. This might have been due to a higher
comorbidity of the patients in the RT alone group. However, data regarding
the patients’ comorbidity were not available.
Similar to our previous study including MSCC patients of any age, the present
study of elderly (> 65 years) patients did not suggest a significant benefit
for decompressive surgery with stabilization or for laminectomy in addition
to radiotherapy with respect to functional outcome, local control of MSCC,
and survival. Surgery- and anesthesia-related risks are important
particularly for elderly patients. Therefore, many of these patients appear
better treated with radiotherapy alone.
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※ 編輯: complainmil 來自: 203.71.94.32 (02/07 22:38)
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02/07 23:05, 1F