Radiotherapy for cervical spine metastases in breast cancer patients

Background: Although cervical spine metastasis in breast cancer patients is the least frequent of metastatic disease to the spinal column, it is nonetheless a clinically important source of morbidity and mortality. The aim of this study was to describe our radiotherapeutic experience of this particular neoplastic complication. Methods: The records of 1,226 women with carcinoma of the breast between 1990 and 2005 were assessed retrospectively for the development of metastatic disease in the cervical spine. Sixteen of these patients underwent palliative radiotherapy for cervical spine metastasis of breast carcinoma origin. Results: The mean interval prior to the appearance of cervical spine metastases was 38.9 months. The most frequently observed clinical manifestations were neck pain (56%) and limb paresis/palsy (38%). Among the evaluable people, the complete and absent subjective response rates were 86 and 14%, respectively; the corresponding objective response rates were both 50%. Other osseous and extra-osseous metastatic lesions were present in the majority of cases (69%). The overall 1-year survival rate was 19%, and median survival was 3 months. Conclusion: Cervical spine metastases in women with breast cancer are associated with a limited chance for survival. Symptomatic patients overall derive palliation from conventional treatment.