Abstract
Purpose: To assess the impact of a multidisciplinary approach for treatment of patients with metastatic epidural spinal cord compression in terms of feasibility, local control, and survival. Methods and Materials: Eighty-nine consecutive patients treated between January 2004 and December 2007 were included. The most common primary cancers were lung, breast, and kidney cancers. Ninety-eight surgical procedures were performed. Radiotherapy was performed within the first month postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan. Nearly all patients (93%) had back pain before treatment, whereas major or minor preoperative neurologic deficit was present in 62 cases (63%). Results: Clinical remission of pain was obtained in the vast majority of patients (91%). Improvement of neurologic deficit was observed in 45 cases (72.5%). Local relapse occurred in 10%. Median survival was 11 months (range, 0-46 months). Overall survival at 1 year was 43.6%. Type of primary tumor significantly affected survival. Conclusions: In patients with metastatic epidural spinal cord compression, the combination of surgery plus radiotherapy is feasible and provides clinical benefit in most patients. The discussion of each single case within a multidisciplinary team has been of pivotal importance in implementing the most appropriate therapeutic approach.
| Original language | English |
|---|---|
| Pages (from-to) | 1467-1473 |
| Number of pages | 7 |
| Journal | International Journal of Radiation Oncology Biology Physics |
| Volume | 78 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Dec 1 2010 |
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Keywords
- Metastatic spinal cord compression
- Multimodal treatment
- Radiotherapy
- Solid tumor
- Surgery
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Radiation
- Cancer Research
Cite this
Multimodal approach to the management of metastatic epidural spinal cord compression (MESCC) due to solid tumors. / Tancioni, Flavio; Navarria, Pierina; Lorenzetti, Martin A.; Pedrazzoli, Paolo; Masci, Giovanna; Mancosu, Pietro; Alloisio, Marco; Morenghi, Emanuela; Santoro, Armando; Rodriguez Y Baena, Riccardo; Scorsetti, Marta.
In: International Journal of Radiation Oncology Biology Physics, Vol. 78, No. 5, 01.12.2010, p. 1467-1473.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multimodal approach to the management of metastatic epidural spinal cord compression (MESCC) due to solid tumors
AU - Tancioni, Flavio
AU - Navarria, Pierina
AU - Lorenzetti, Martin A.
AU - Pedrazzoli, Paolo
AU - Masci, Giovanna
AU - Mancosu, Pietro
AU - Alloisio, Marco
AU - Morenghi, Emanuela
AU - Santoro, Armando
AU - Rodriguez Y Baena, Riccardo
AU - Scorsetti, Marta
PY - 2010/12/1
Y1 - 2010/12/1
N2 - Purpose: To assess the impact of a multidisciplinary approach for treatment of patients with metastatic epidural spinal cord compression in terms of feasibility, local control, and survival. Methods and Materials: Eighty-nine consecutive patients treated between January 2004 and December 2007 were included. The most common primary cancers were lung, breast, and kidney cancers. Ninety-eight surgical procedures were performed. Radiotherapy was performed within the first month postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan. Nearly all patients (93%) had back pain before treatment, whereas major or minor preoperative neurologic deficit was present in 62 cases (63%). Results: Clinical remission of pain was obtained in the vast majority of patients (91%). Improvement of neurologic deficit was observed in 45 cases (72.5%). Local relapse occurred in 10%. Median survival was 11 months (range, 0-46 months). Overall survival at 1 year was 43.6%. Type of primary tumor significantly affected survival. Conclusions: In patients with metastatic epidural spinal cord compression, the combination of surgery plus radiotherapy is feasible and provides clinical benefit in most patients. The discussion of each single case within a multidisciplinary team has been of pivotal importance in implementing the most appropriate therapeutic approach.
AB - Purpose: To assess the impact of a multidisciplinary approach for treatment of patients with metastatic epidural spinal cord compression in terms of feasibility, local control, and survival. Methods and Materials: Eighty-nine consecutive patients treated between January 2004 and December 2007 were included. The most common primary cancers were lung, breast, and kidney cancers. Ninety-eight surgical procedures were performed. Radiotherapy was performed within the first month postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan. Nearly all patients (93%) had back pain before treatment, whereas major or minor preoperative neurologic deficit was present in 62 cases (63%). Results: Clinical remission of pain was obtained in the vast majority of patients (91%). Improvement of neurologic deficit was observed in 45 cases (72.5%). Local relapse occurred in 10%. Median survival was 11 months (range, 0-46 months). Overall survival at 1 year was 43.6%. Type of primary tumor significantly affected survival. Conclusions: In patients with metastatic epidural spinal cord compression, the combination of surgery plus radiotherapy is feasible and provides clinical benefit in most patients. The discussion of each single case within a multidisciplinary team has been of pivotal importance in implementing the most appropriate therapeutic approach.
KW - Metastatic spinal cord compression
KW - Multimodal treatment
KW - Radiotherapy
KW - Solid tumor
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=78549256374&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78549256374&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2009.09.038
DO - 10.1016/j.ijrobp.2009.09.038
M3 - Article
C2 - 20231072
AN - SCOPUS:78549256374
VL - 78
SP - 1467
EP - 1473
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
SN - 0360-3016
IS - 5
ER -