| Metastatic spinal cord compression. Influence of time between onset of motoric deficits and start of irradiation on therapeutic effect. | |
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MedLine Citation:
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PMID: 10481768 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In a retrospective analysis we investigated the prognostic significance of the interval between first appearance of motoric deficits and the beginning of radiation therapy (RT) with regard to posttreatment motoric function. MATERIAL AND METHODS: Data of more than 400 consecutive patients being irradiated at our department between 1994 and 1997 because of vertebral metastases were reviewed. Ninety-six patients fulfilled selection criteria including motoric deficits, no preceding surgical or radiotherapeutic treatment of the spine, minimum total dose of 24 Gy referred to spinal cord, and additional treatment with dexamethasone. Two subgroups with a similar number of patients for better comparability were formed according to the time of developing motoric deficits: 1 to 13 days (49 patients) and > or = 14 days (47 patients). Effect of irradiation on motoric function was evaluated 2 weeks and about 3 months after radiotherapy. Patients with severe deterioration of motoric function within 48 hours before radiation therapy (31 patients) were looked at separately. RESULTS: Two weeks after radiotherapy 42/47 patients (89%) developing motoric deficits > or = 14 days showed improvement of motoric function in comparison to 6/49 patients (12%) of the other group. Deterioration occurred in 1/47 patients (2%) of the first and in 24/49 patients (49%) of the latter group. In case of severe deterioration of motoric function within 48 hours before radiation therapy only 2/31 patients (6%) showed improvement, but 20/31 (65%) deterioration. About 3 months after radiotherapy comparable results were observed. Median survival time was 4 months. CONCLUSION: A slower development of motoric deficits before beginning of radiotherapy means a better therapeutic effect and a more favorable functional outcome after treatment. The prognosis is extraordinarily poor if severe deterioration of motoric function occurs within 48 hours before radiotherapy. |
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Authors:
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D Rades; M Blach; V Nerreter; M Bremer; J H Karstens |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al] Volume: 175 ISSN: 0179-7158 ISO Abbreviation: Strahlenther Onkol Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-09-16 Completed Date: 1999-09-16 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8603469 Medline TA: Strahlenther Onkol Country: GERMANY |
Other Details:
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Languages: eng Pagination: 378-81 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, Medical School, Hanover, Germany. rades.dirk@mh-hannover.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Neoplasm Metastasis Neoplasms / complications, physiopathology*, radiotherapy* Prognosis Psychomotor Performance* Radiotherapy Dosage Retrospective Studies Spinal Cord Compression / etiology* Time Factors |
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