A predictive tool particularly designed for elderly myeloma patients presenting with spinal cord compression

BMC Cancer

Research Article

Niklas Gebauer¹  Tobias Bartscht¹  Antonio Jose Conde-Moreno²  Jon Cacicedo³  Dirk Rades⁴  Theo Veninga⁵  Steven E. Schild⁶ 

[1] Department of Hematology & Oncology, University of Lubeck, Lubeck, Germany;Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón, Spain;Department of Radiation Oncology, Cruces University Hospital, Barakaldo, Vizcaya, Spain;Department of Radiation Oncology, University of Lubeck, Ratzeburger Allee 160, D-23538, Lubeck, Germany;Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, Netherlands;Mayo Clinic, Scottsdale, AZ, USA;

关键词: Myeloma;    Elderly patients;    Spinal cord compression;    Radiotherapy;    Overall survival;    Predictive tool;   

DOI  :  10.1186/s12885-016-2325-y

 received in 2015-10-02, accepted in 2016-04-20,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThis study was performed to design a predictive tool that allows the estimation of overall survival (OS) of elderly myeloma patients (aged ≥65 years) presenting with myeloma-induced spinal cord compression (SCC).MethodsOne-hundred-and-sixteen patients irradiated for motor deficits of the legs due to myeloma-induced spinal cord compression were retrospectively evaluated. Ten characteristics were analyzed for OS including age, interval between myeloma diagnosis and radiotherapy, other osseous myeloma lesions, myeloma type, gender, time developing motor deficits, number of affected vertebrae, ECOG-PS, pre-radiotherapy ambulatory status, and fractionation regimen. Characteristics that achieved significance on multivariate analysis were included in the predictive tool. The score for each characteristic was obtained from the 1-year OS rate divided by 10. The sum of these scores represented the prognostic score for each patient.ResultsOn multivariate analysis, myeloma type (hazard ratio 3.31; 95 %-confidence interval 1.75–6.49; p < 0.001), ECOG-PS (HR 5.33; 95 %-CI 2.67–11.11; p < 0.001), ambulatory status (HR 2.71; 95 % CI 1.65–4.57; p < 0.001), and age (HR 1.95; 95 % CI 1.03–3.78; p = 0.040) were significantly associated with survival. Sum scores ranged from 18 to 32 points. Based on the sum scores, three prognostic groups were designed: 18–19, 21–28 and 29–32 points. The corresponding 1-year survival rates were 0, 43 and 96 %, respectively (p < 0.001).ConclusionsThis new predictive tool has been specifically designed for elderly myeloma patients with SCC. It allows estimating the survival prognosis of this patient group and supports the treating physicians when looking for the optimal treatment approach for an individual patient.

【 授权许可】

CC BY   
© Rades et al. 2016