Symptom Outcomes of Cancer Patients With Clival Metastases Treated With Radiotherapy: A Study of 44 Patients

Anticancer Res. 2021 Oct;41(10):5001-5006. doi: 10.21873/anticanres.15314.

Abstract

Background/aim: To describe clinical features, radiotherapy (RT), and symptom outcomes in cancer patients with cranial nerve palsies associated with clival metastases.

Patients and methods: This is a retrospective review of patients with primary metastatic cancers who developed clival metastases and received RT (2000-2020).

Results: Of the 44 patients with primary cancers (manly breast, prostate and multiple myeloma cancers) and distal clival metastases, 32 patients (73%) also had cervical spine metastases. Of the 23 RT-treated patients, 65% and 35% received clivus only and whole brain RT, respectively. Post-RT symptom improvement was observed in patients with diplopia (5/6; 83%), headache (8/10; 80%), chin numbness (2/4; 50%), blurry vision (2/5; 40%), lateral gaze deficit (2/6; 33%), and tongue deviation (1/4; 25%).

Conclusion: Early detection and cranial nerve examination, in addition to RT treatment, should be considered in patients with breast, prostate, and multiple myeloma cancers, who developed cervical spine metastases.

Keywords: Clival metastasis; cranial nerve palsy; radiotherapy; symptom improvement.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cranial Fossa, Posterior / pathology*
  • Cranial Fossa, Posterior / radiation effects
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / pathology*
  • Neoplasms / radiotherapy
  • Prognosis
  • Retrospective Studies
  • Skull Base Neoplasms / radiotherapy
  • Skull Base Neoplasms / secondary*
  • Survival Rate
  • Symptom Assessment / methods*