Impact of quality of life on survival in a prospective study of radiotherapy for patients with metastatic spinal cord compression

The multicenter prospective SCORAD in the UK compared two radiation therapy dosing schemes for patients with metastatic spinal cord compression (MSCC). The primary end point has been published previously. Analysis of the impact of health-related quality of life on outcomes has now been published. Patients with a baseline physical functioning score of above 50 demonstrated a 28% reduction in the risk of death (HR 0.72; p=0.03), whereas an increased risk of death was associated with fatigue (HR 1.35; p=0.0040), dyspnea (HR 1.61; p<0.001), and appetite loss (HR 1.25; p=0.014). The preferred place of care for the majority was at home or with relatives, but only half were able to achieve this. The authors conclude that among MSCC patients receiving radiation therapy, prolonged survival was seen in patients in patients with better health-related quality of life.