Radiation therapy of spinal metastases in beast cancer: retrospective analysis of 108 patients

Retrospective analysis of analgesic, decompressive and re-mineralization effects of radiation therapy for spinal metastases in breast cancer. From January 1990 to December 1992, 108 patients with breast cancer were treated by irradiation at the Bergonie Institute for a first spinal metastasis. three patients had undergone previous surgery (laminectomy and Doves' frame). The indication of radiation therapy was analgesic (102 patients) or decompressive (six patients). The usual irradiation scheme was 30 Gy/ 10 fractions / 2 weeks. The analgesic effect was considered as 'complete' or 'almost complete' (83%), 'moderate' (13 %) or absent (4 %). The mean time to the maximum analgesic response was 35 days. The duration of both the analgesic response and re-mineralization effects could not be retrospectively assessed due to lack of data. Decompressive effects were complete in five cases and absent in one case. A second spinal radiation therapy was necessary 78 times (eight times in junction field within 6 months following the first treatment). Spinal cord compression occurred either out of (three cases) or within (one case) the irradiated field. Radiation therapy for spinal metastases in breast cancer remains a palliative analgesic treatment. Indication for decompressive 'risk' leads to discussion of radiological stating (contribution of magnetic resonance imaging) and possible previous treatment (vertebro-plasty or osteosynthesis). (author)