Predictors of outcomes and a scoring system for estimating survival in patients treated with radiotherapy for metastatic spinal cord compression from small-cell lung cancer (SCLC)

Abstract Purpose To identify prognostic factors and create a survival score to facilitate individualized care of patients with metastatic spinal cord compression (MSCC) from small-cell lung cancer (SCLC). Patients and Methods Radiation regimen plus 9 factors were retrospectively evaluated in 120 patients irradiated for MSCC from SCLC for overall response, improvement of motor deficits, postradiotherapy ambulatory status, local control of MSCC, and overall survival (OS). Factors included age, interval diagnosis of SCLC to radiotherapy (RT) of MSCC, visceral metastases, further bone metastases, gender, time developing motor deficits, pre-RT ambulatory status, number of affected vertebrae, and Eastern Cooperative Oncology Group performance status (ECOG PS). Results Improvement of motor deficits showed significant associations with ECOG PS 1-2 ( P  = .018); time developing motor deficits achieved borderline significance ( P  = .059). Post-RT ambulatory status was significantly associated with slower development of motor dysfunction ( P  = .003), ambulatory status ( P P P  = .004), visceral metastases ( P P  = .002), and ECOG PS ( P  = .002). For the survival score, 6-month OS rates related to each of these factors were divided by 10. Patient scores were obtained by adding these factors' scores. Three groups were defined (5, 7-13, and 15-17 points) with 6-month OS rates of 0, 18%, and 77%, respectively ( P Conclusion Predictors of various outcomes were identified and a survival score was created that can support physicians aiming to create personalized treatments to patients with MSCC from SCLC.