Should 4 Gy x 5 be the standard of care for spinal cord compression in patients with poor prognosis?
The randomized SCORE-2 trial demonstrated equivalent survival (median 3 vs 3.7 months), response rates (72% vs 74% ambulatory at 1 month), and durability of palliation (~80% of survivors ambulatory at 6 months in both arms) between 4 Gy x 5 and 3 Gy x 10 when treating cord compression in patients with poor prognosis, as defined by a validated prognostic scoring system.
Given that one extra week of RT is a significant investment for those with only 3-4 months median survival, should 4 Gy x 5 be the standard of care in this patient population?
1 Answer
Mednet Member
Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on
Wow, so this question was asked in 2016 and nobody has taken a whack at it.
30 Gy in 10 fx has been the long-standing standard dose for SCC in most countries for just about ever. This has not been compared to other doses until more recently. 30/10 works well, is relatively short (2 weeks), and utili...
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