Radiotherapy treatment of spinal metastases in Ibadan: A 9-year review

Background: Metastatic spinal tumors signify disease progression and result in poor quality of life of patients. We are likely to see an increasing burden of spinal metastases due to the global trend of increasing cancer survival. Objective: The objective of this study was to review the pattern of presentation and radiotherapy of metastatic spinal tumors in the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria. Materials and Methods: The radiation therapy records of all patients who received spinal irradiation between January 2007 and December 2015 were retrieved. The extracted data are patients' sociodemographic, clinicopathologic, and treatment factors which include the radiation dose given and retreatment dose. Results: Majority (91.7%) of the patients who had radiotherapy to the spine had metastatic spinal tumors. Male patients accounted for 69.1% of the cases and females accounted for 30.1% resulting in a male-female ratio of 2.23:1. Close to half (45.8%) of the patients were elderly. Prostate cancer (57.3%) and breast cancer (18.8%) were the most common primary sites. The most common involved spinal site was the thoracic region. In all age groups, fewer patients received a short radiotherapy treatment course (totaling 15 Gy or less and within a duration of 1 week) versus long radiotherapy treatment course (other radiation schedules not meeting criteria for short). Conclusion: A high index of suspicion of metastatic spinal cancer is required, particularly for breast and prostate cancers. The authors recommend that more elderly patients should be treated with short-course radiotherapy.