Radiation Therapy for Metastatic Spinal Cord Compression in Patients with Hepatocellular Carcinoma

Abstract

Aim: This is the first study to investigate patients with metastatic spinal cord compression (MSCC) from hepatocellular carcinoma (HCC).

Patients and methods: Eight patients were analyzed with regard to survival and motor dysfunction.

Results: Out of seven factors (age, affected vertebrae, ambulatory status, bone lesions, other distant metastases, time developing motor dysfunction, performance score) ambulatory status (p=0.005) and distant metastases (p=0.032) had a significant influence on survival. Both factors were used as a predictive tool (points: not ambulatory 0, ambulatory 1, distant metastases 0, no distant metastases 1). Total scores were 0, 1 or 2 points. Three-month survival rates were 0%, 67% and 100%, six-month survival rates 0%, 0% and 100%. Progression of motor dysfunction was prevented in 63% of patients; time developing motor deficits showed a trend (p=0.08).

Conclusion: Many patients with MSCC from HCC have a short survival, which can be predicted with a new tool. Radiation therapy can stop progression of motor dysfunction.

Keywords: Hepatocellular carcinoma; metastatic spinal cord compression; motor dysfunction; radiation therapy; survival.