S868
Clinical - Mixed sites & palliation
ESTRO 2026
logistic regression analysis revealed lack of previous spinal radiotherapy was significantly associated with MSCC within 12 months (OR 2.82, P=0.005). No other characteristics showed a statistically significant association with earlier MSCC. However, of patients with biopsy data (n=108) those with GS ≥ 9 disease (13 months (6-24) trended towards developing MSCC earlier than those with GS ≤ 8 (19 months (8-34)) P=0.214).
Digital Poster 1124
Risk factors that may predict time to development of metastatic spinal cord compression in patients with metastatic castrate resistant prostate cancer Alexander Batty 1 , Maria Vassilou 2 , Kate Lacey 1 , Helen Wong 1 , Richard Walshaw 1 1 Clinical Oncology, Clatterbridge Cancer Centre, Liverpool, United Kingdom. 2 Clinical Oncology, The Christie, Manchester, United Kingdom Purpose/Objective: Malignant spinal cord compression (MSCC) is a major cause of morbidity and mortality in patients with metastatic castrate resistant prostate cancer (mCRPC). MSCC outcomes improve with treatment prior to development of neurological deficit, but screening to detect and treat MSCC in mCRPC patients prior to clinical presentation has not been proven to be beneficial(1). There is emerging evidence to suggest some patients with spinal metastases may benefit from prophylactic radiotherapy prior to the development of symptoms(2). In this study risk factors in mCRPC patients who developed impending or established MSCC were analysed to determine which may contribute to faster development of MSCC. Material/Methods: Patients were identified retrospectively who had previously commenced on systemic treatment for mCRPC and presented to a regional MSCC service with confirmed MSCC between 2017 and 2020. Characteristics including Gleason score (GS), baseline PSA, PSA kinetics and previous radiotherapy to the spine prior to MSCC were collected. Time from commencing treatment for mCRPC and occurrence of MSCC was compared between groups. Mann Whitney U test was used to assess significance and multivariate logistic regression analysis assessed for factors associated with MSCC within 12 months. Results: 133 patients were included. Table 1 shows patient risk factor and time to MSCC data. Median age was 74 (range 50-90), median time from mCRPC to MSCC was 17 months (1-102). Median time for development of MSCC in patients who had previous Radiotherapy to the spine (21 months- (interquartile range=11-33)) was significantly longer than in those who were treatment naive (11.5 months (6-22) p = 0.004). Multivariate
Conclusion: This study suggests prior radiotherapy for spinal metastases in the absence of MSCC is associated with longer time from development of mCRPC to MSCC. This leads to the hypothesis that radiotherapy prior to MSCC abrogates or delays potential progression of that irradiated metastases to cause SCC. This supports the development of studies investigating the role of prophylactic irradiation to spinal metastases in mCRPC. Further work is needed to determine the risk factor profile of patients who may benefit most from such treatment. References: 1. Dearnaley D, Hinder V, Hijab A, Horan G, Srihari N, Rich P, et al. Observation versus screening spinal MRI and pre-emptive treatment for spinal cord compression in patients with castration-resistant prostate cancer and spinal metastases in the UK (PROMPTS): an open-label, randomised, controlled, phase 3 trial. Lancet Oncol. 2022 Apr 1;23(4):501–13. 2. Gillespie EF, Yang JC, Mathis NJ, Marine CB, White C, Zhang Z, et al. Prophylactic Radiation Therapy Versus Standard of Care for Patients With High-Risk Asymptomatic Bone Metastases: A Multicenter, Randomized Phase II Clinical Trial. Journal of Clinical Oncology. 2024 Jan 1;42(1):38–46. Keywords: Palliative, Cord Compression, Prostate Cancer,
Digital Poster 1150 Percutaneous Ablation and Cementoplasty
Made with FlippingBook - Share PDF online