ROLE OF PALLIATIVE RADIOTHERAPY IN IMPROVING PERFORMANCE STATUS AND QUALITY OF LIFE IN PATIENTS WITH METASTATIC SPINAL CORD COMPRESSION

Authors

  • Fawad Ul Qamar shaukat khanum memorial cancer hospital
  • Kashif Sajjad shaukat khanum memorial cancer hospital
  • Irfan Haider shaukat khanum memorial cancer hospital
  • Fattah Ullah Khan shaukat khanum memorial cancer hospital
  • Yasir Inam Shaukat khanum memorial cancer hospital and research center
  • Maheen Anjum shaukat khanum memorial cancer hospital

DOI:

https://doi.org/10.55519/JAMC-04-S4-10570

Keywords:

palliative radiotherapy, quality of life, performance status

Abstract

Background: Palliative radiotherapy in patients with metastatic spinal cord compression is a well-known treatment modality but little is known whether it improves quality of life and performance status. Our study focusses on analyzing the impact of palliative radiotherapy on these two parameters in patients with metastatic spinal cord compression. Methods: We performed a prospective observational study from August 2020 to April 2021 to assess consecutive patients presenting to emergency department with suspected MSCC. We enrolled 24 patients in the study, and they were evaluated for their performance status and quality of life using ECOG and FACIT-PAL 14 scores respectively. Palliative radiotherapy was administered, and the patients were followed up four to six weeks later. Their ECOG and FACIT-PAL 14 scores before and after receiving palliative radiotherapy were analyzed. Results: The mean age of the patients was 48 (IQR 35–62), with 14 (58%) being male. 1 patient died soon after admission. Median dose fractionation was 2000 cGy. Median (IQR) of ECOG performance status score on admission and follow up was 2.5 (1.0–3.7) and 1.5 (1.0–3.7), p=0.719, respectively. Median (IQR) FACIT-PAL 14 score on admission and follow up were 35.5 (34.0–37.6) and 36.5 (30.2-44.7), p=0.277, respectively. Our results indicate that there was no statistically significant difference in the median ECOG performance status and FACIT PAL 14 scores before and after the administration of palliative radiotherapy. Conclusion: Our study indicates that palliative radiotherapy in patients with metastatic spinal cord compression had little benefit in objectively improving quality of life and performance status using the well-known and widely used scores. This lack of response could be due to delayed presentation of the patients. Earlier involvement of palliative care team could have improved both these parameters. Further research with larger population of patients over a longer period is needed to further assess these outcomes.

Author Biographies

Fawad Ul Qamar, shaukat khanum memorial cancer hospital

HOD and consultant  clinical and radiation oncology 

Kashif Sajjad, shaukat khanum memorial cancer hospital

associate medical director and pallative care consultant  departemt of pallative and internal medicine 

Irfan Haider, shaukat khanum memorial cancer hospital

consultant  clinical and radiation oncology department 

Fattah Ullah Khan , shaukat khanum memorial cancer hospital

consultant and head of department  pallative care and internal medicine department 

Yasir Inam, Shaukat khanum memorial cancer hospital and research center

resident R3  clinical and radiation oncology department 

Maheen Anjum, shaukat khanum memorial cancer hospital

medical officer  clinical and radiation oncology department 

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Published

2022-10-11

Issue

Vol. 34 No. 4(SUPPL 1) (2022): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

ORIGINAL ARTICLE

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