Palliative Care

PV QA 3 - Poster Viewing Q&A 3

TU_30_3033 - Palliative Radiation Therapy for Spinal Metastasis from Myxoid Liposarcoma

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Palliative Radiation Therapy for Spinal Metastasis from Myxoid Liposarcoma
A. Harada1, M. Sumi2, T. Toshiyasu2, Y. Yoshioka2, Y. Takazawa3, K. Ae4, S. Matsumoto5, and M. Oguchi2; 1Radiation Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo 135-8550, Japan, 2Radiation Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan, 3Pathology Department, The Cancer Institute Hospital, the Japanese Foundation for Cancer Research, Tokyo, Japan, 4Orthopedic Surgery Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan, 5Sarcoma Center, The Cancer Institute Hospital, the Japanese Foundation for Cancer Research, Tokyo, Japan

Purpose/Objective(s): Myxoid liposarcoma is known to be sensitive to Radiation Therapy (RT) compared to other soft tissue sarcomas. However, the efficacy of palliative RT to myxoid liposarcoma metastasis is not well elucidated in literature. The purpose of this study is to investigate the pain reduction and neurological improvement with RT for spinal metastasis from myxoid liposarcoma.

Materials/Methods: We retrospectively reviewed 31 metastases to the spine from myxoid liposarcoma in 16 patients treated with RT between January 2005 and December 2014 at a single institution. Spinal cord compression or root compression were diagnosed radiologically by CT or MRI images. All patients were evaluated with the degree of the pain, motor, sensory and sphincter control disturbances, prior and post to RT. The Numeric Rating Scale (NRS) was used to assess pain. The Manual Muscle Testing (MMT) was used to assess motor function. The number of dermatomes presenting paresthesia was used to assess sensory function. Radiation response was evaluated comparing the worst score collected before or during RT with the score collected 1-3 months after treatment. Pain reduction was defined as 2 scores or more decrease in NRS or reduced pain medication. Improvement in motor function was defined as 1 score increase in MMT. Improvement in sensory function was defined as decrease in number of dermatomes associated with paresthesia. Corticosteroids were administered according to the patient’s neurological symptoms.

Results: The characteristics of patients were following; median age 52 years (range, 17-68 years), gender male:12 female:4. The irradiated vertebrae were the following; 5 cervical, 14 thoracic, 10 lumbar, and 2 sacrum. The majority of the bone metastases were multiple, and the median RT course per patient was 2 (range 1-3), and there was 1 reirradiation. There were 15 spinal cord compressions and 12 root compressions. The symptoms were pain, motor weakness, sensory disturbance, and sphincter dysfunction from 30, 8, 5, and 3 lesions, respectively. The median radiation dose was 30 Gy in 10 fractions. Seven Gy in 1 fraction was used in the reirradiation plan. Conventional 3-dimensional conformal RT was delivered. Corticosteroids were administered in 7 patients. The median follow-up time was 19.6 months (range, 2-72 months). The improvement rate of pain, motor, sensory and sphincter control were 63% (19/30 lesions), 50% (4/8 lesions), 20% (1/5 lesions), and 0% (0/3 lesions), respectively. Post-RT MRI image was obtained in 7 lesions out of the 15 lesions diagnosed with spinal cord compression, and removal of cord compression was demonstrated in all 7 lesions.

Conclusion: Palliative RT is effective for pain relief and neurological improvement for spinal metastasis from myxoid liposarcoma, even with spinal cord compression.

Author Disclosure: A. Harada: None. M. Sumi: None. T. Toshiyasu: None. Y. Yoshioka: None. K. Ae: None.

Arisa Harada, MD, PhD

Presentation(s):

Send Email for Arisa Harada


Assets

TU_30_3033 - Palliative Radiation Therapy for Spinal Metastasis from Myxoid Liposarcoma



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Palliative Radiation Therapy for Spinal Metastasis from Myxoid Liposarcoma