Rades评分对转移性脊髓压迫症放疗相关生存预后的评估价值分析

Evaluation value of Rades score on radiotherapy-related survival prognosis in patients with metastatic spinal cord compression

目的评价Rades评分对转移性脊髓压迫症(MSCC)患者放疗相关生存预后的评估价值。方法回顾性分析中国科学院大学附属肿瘤医院2010年1月至2014年1月110例行放疗的MSCC患者的临床资料,原发肿瘤为前列腺癌36例,骨髓瘤/淋巴瘤18例,乳腺癌15例,肺癌7例,其他类型癌34例。记录患者的生存情况、总生存期及Rades评分,分析影响患者生存预后的因素及Rades评分与生存预后的关系。结果84.5%(93/110)患者放疗剂量为20 Gy/5次;5.5%(6/110)患者放疗剂量为30 Gy/10次,为术后患者或骨髓瘤/淋巴瘤患者。行手术治疗37例。患者随访(38.6±15.2)个月,总生存期(15.2±0.5)个月。Cox比例风险模型分析结果显示,原发肿瘤类型、手术治疗、联合化疗和Rades评分是影响MSCC患者生存预后的危险因素(P<0.05)。110例患者中,Rades评分20~30分17例(A组),31~35分40例(B组),36~45分53例(C组)。C组6个月生存率明显高于A组和B组[45.3%(24/53)比0和27.5%(11/40)],差异有统计学意义(P<0.05);C组5年生存率为22.6%(12/53),A组和B组5年生存率均为0。结论Rades评分与MSCC患者的生存预后有关,可辅助制定MSCC患者的放疗方案。

Objective To evaluate the radiotherapy-related survival prognosis value of Rades score in patients with metastatic spinal cord compression(MSCC).Methods The clinical data of 110 patients with MSCC who underwent radiotherapy from January 2010 to January 2014 in Cancer Hospital of the University of Chinese Academy of Sciences were retrospectively analyzed.The primary tumor was 36 cases of prostate cancer,18 cases of myeloma/lymphoma,15 cases of breast cancer,7 cases of lung cancer,and 34 cases of other types of cancer.The survival status,overall survival time and Rades score were recorded.The influencing factors of survival prognosis and the relationship between the Rades score and survival prognosis were analyzed.Results The 84.5%(93/110)patients had a radiotherapy dose of 20 Gy/5 times;5.5%(6/110)patients(operated patients or myeloma/lymphoma patients)had a radiotherapy dose of 30 Gy/10 times.Thirty-seven cases were treated by surgery.The patients were followed up for(38.6±15.2)months,and the overall survival period was(15.2±0.5)months.Cox proportional hazards model analysis result showed that the primary tumor type,surgical treatment,combined chemotherapy and Rades score were the risk factors of survival prognosis in patients with MSCC(P<0.05).Among the 110 patients,Rades score was 20 to 30 scores in 17 cases(group A),31 to 35 scores in 40 cases(group B),and 36 to 45 scores in 53 cases(group C).The 6-month survival rate in group C was significantly higher than that in groups A and group B:45.3%(24/53)vs.0 and 27.5%(11/40),and there was statistical difference(P<0.05).The 5-year survival rate in group C was 22.6%(12/53),and the 5-year survival rates in both groups A and group B were 0.Conclusions Rades score is related to the survival prognosis of MSCC patients,and can assist in formulating radiotherapy programs for MSCC patients.