Document Detail


Prognostic factors in the management of metastatic epidural spinal cord compression.
MedLine Citation:
PMID:  6678303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The results of 51 patients with metastatic spinal cord compression were analyzed. There were seven paralyzed patients, three received radiotherapy (RT) alone and four received laminectomy (L) + RT. No patient regained any motor function. Of six ambulatory patients, half received RT and half L + RT. All remained ambulatory after the treatment. Of 38 paraparetic patients, 20 underwent L + RT. Their complete, partial and nonresponse (CR, PR, NR respectively) rates were 25%, 60% and 15%, respectively. This result was clearly better than 18 other patients treated by RT alone of which only 22% regained ambulation (CR = 22%) while 67% were NR and 11% had a PR. In this series combined modality therapy appears better in paraparetic patients. Five patients with radiosensitive tumors all had CR/PR whether treated by RT or L + RT. Patients with epithelial tumors treated by L + RT had a PR (CR + PR) of 71% while RT alone gave only 25%. On the basis of this analysis we conclude: (1) ambulatory patients respond satisfactorily to RT alone; (2) paraparetic patients with radiosensitive tumors do well with RT alone while such patients with epithelial tumors merit L + RT; but (3) paraplegic patients rarely benefit from either modality; (4) pain control appears a useful measure of minimally adequate radiation dose in individual patients.
Authors:
S G Tang; J E Byfield; T R Sharp; J F Utley; L Quinol; S L Seagren
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neuro-oncology     Volume:  1     ISSN:  0167-594X     ISO Abbreviation:  J. Neurooncol.     Publication Date:  1983  
Date Detail:
Created Date:  1984-09-19     Completed Date:  1984-09-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8309335     Medline TA:  J Neurooncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  21-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Combined Modality Therapy
Epidural Space
Female
Humans
Laminectomy
Male
Middle Aged
Paralysis / etiology,  therapy
Prognosis
Spinal Cord Compression / etiology,  therapy*
Spinal Neoplasms / complications,  radiotherapy,  secondary*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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