Multimodal approach to the management of metastatic epidural spinal cord compression (MESCC) due to solid tumors

Flavio Tancioni, Pierina Navarria, Martin A. Lorenzetti, Paolo Pedrazzoli, Giovanna Masci, Pietro Mancosu, Marco Alloisio, Emanuela Morenghi, Armando Santoro, Riccardo Rodriguez Y Baena, Marta Scorsetti

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1467-1473
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume78
Issue number5
DOIs
Publication statusPublished - Dec 1 2010

Keywords

  • Metastatic spinal cord compression
  • Multimodal treatment
  • Radiotherapy
  • Solid tumor
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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