Table 1.
Univariate analysis | Multivariate analysis | ||||||
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|
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No. of patients | MS, mo | p-value* | Coefficient | HR | 95% CI | p-value† | |
Age, yr | 0.492 | - | - | - | - | ||
≤55 | 86 | 4.8 | |||||
>55 | 106 | 3.9 | |||||
Gender | 0.430 | - | - | - | - | ||
Male | 157 | 4.5 | |||||
Female | 35 | 5.3 | |||||
ECOG performance status | <0.001 | 0.639 | 1.895 | 1.302–2.757 | 0.001 | ||
0–2 | 104 | 5.7 | |||||
3–4 | 88 | 2.7 | |||||
AFP, ng/mL | 0.143 | - | - | - | - | ||
≤200 | 98 | 4.7 | |||||
>200 | 94 | 2.8 | |||||
Child-Pugh classification | 0.025 | 0.259 | 1.165 | 0.693–1.755 | 0.164 | ||
A, B | 172 | 4.5 | |||||
C | 20 | 2.0 | |||||
Primary HCC | <0.001 | 1.279 | 3.595 | 2.453–5.268 | <0.001 | ||
Controlled | 127 | 6.2 | |||||
Uncontrolled | 65 | 1.9 | |||||
Interval from diagnosis of primary tumor to spinal metastases, mo | 0.966 | - | - | - | - | ||
≤9 | 100 | 4.2 | |||||
>9 | 92 | 4.0 | |||||
Baseline BPI score (pain severity) | 0.857 | - | - | - | - | ||
≤6 | 114 | 4.8 | |||||
>6 | 78 | 4.2 | |||||
Extrahepatic metastases other than bone | 0.012 | −0.560 | 0.571 | 0.391–0.835 | 0.004 | ||
Yes | 50 | 2.8 | |||||
No | 142 | 5.0 | |||||
Site of spinal metastasis | 0.169 | - | - | - | - | ||
Cervical | 26 | 2.5 | |||||
Thoracic | 46 | 4.8 | |||||
Lumbar | 48 | 5.7 | |||||
Sacrum | 8 | 4.5 | |||||
Combined (2 sites or more) | 64 | 3.7 | |||||
Multiplicity of spinal metastases | 0.112 | - | - | - | - | ||
Yes | 105 | 5.0 | |||||
No | 87 | 3.9 | |||||
Mass-type metastases | 0.577 | - | - | - | - | ||
Yes | 46 | 4.7 | |||||
No | 146 | 4.5 | |||||
Spinal cord compression (ASIA scale A–C) | 0.839 | - | - | - | - | ||
Yes (A–C) | 25 | 4.0 | |||||
No (D, E) | 167 | 4.5 | |||||
Pathologic fracture | 0.003 | −0.342 | 0.710 | 0.476–1.059 | 0.093 | ||
Yes | 47 | 2.7 | |||||
No | 145 | 5.0 | |||||
BED, Gy10 | <0.001 | −0.624 | 0.536 | 0.383–0.751 | <0.001 | ||
≤38 | 38 | 2.4 | |||||
39–53 | 132 | 9.7 | |||||
>53 | 22 | 15.2 | |||||
Treatment modalities | 0.926 | - | - | - | - | ||
RT alone | 140 | 3.9 | |||||
RT+CTx | 38 | 4.0 | |||||
RT+S±CTx | 14 | 5.3 | |||||
RT technique | 0.110 | - | - | - | - | ||
Conventional (2D) | 107 | 3.9 | |||||
3D-CRT of IMRT | 85 | 4.5 | |||||
Pain response | 0.001 | 0.308 | 1.361 | 0.938–1.973 | 0.104 | ||
CR | 41 | 7.2 | |||||
Non-CR | 151 | 3.0 |
Adapted from Choi C, Seong J. Gut Liver 2015;9:94–102.4
MS, median survival; HR, hazard ratio; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; AFP, α-fetoprotein; HCC, hepatocellular carcinoma; BPI, brief pain inventory; ASIA, American Spinal Injury Association; BED, biologically effective dose; RT, radiotherapy; CTx, chemotherapy; S, surgery; 2D, 2-dimensional; 3D-CRT, 3-dimensional conformal radiation therapy; IMRT, intensity-modulated radiation therapy; CR, complete pain response.
Determined using the log-rank test;
Determined using the Cox proportional hazard model.