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When should you use single-fraction radiotherapy for spinal cord compression?
Based on the SCORAD III trial, will you now be treating patients with spinal cord compression with single-fraction radiotherapy? Is there anyone you would NOT utilize single-fraction radiotherapy in?
Answer from: Radiation Oncologist at Academic Institution
The SCORAD III trial is practice changing. But I do NOT plan to treat ALL patients with spinal cord compression with a single fraction of 8 Gy now. Here is why: SCORAD III is extremely important new study for the management of metastatic epidural spinal cord compression (MESCC) for patients wi...
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Answer from: Radiation Oncologist at Academic Institution
I wouldn't change practice based solely upon an abstract. However, I believe that the main point of this study as well as others that have investigated the use of 800cGyx1 is that it is appropriate for patients who only require short term benefits from treatment. According to the abstract, the...
Answer from: Radiation Oncologist at Academic Institution
The short answer to this question of using single fraction radiation is yes for all patients who are neurologically intact or who have minimal neurological signs (ie, muscle power ≥ 4/5, functional paresis); one can use single fraction palliative treatment for patients who may have a limited surv...
Answer from: Radiation Oncologist at Academic Institution
I agree that single fraction palliative radiotherapy should be used for patients with malignant epidural spinal cord compression (MESCC). There are now multiple randomized datasets supporting this recommendation. Maranzano et al published a study of 30Gy in 8 fx vs 16 Gy in 2 fx showing ...
Answer from: Radiation Oncologist at Academic Institution
I honestly have to say that I have not used 800 cGy single fraction in spinal cord compression but I have used it a lot for painful bone metastases. It was good to review the SCORAD III data and I will keep this in mind for my discussion with patients but I think 2000 cGy in 5 fractions will still b...