Treatment of spinal epidural metastasis improves patient survival and functional state. Neurology 2002 May 14;58(9):1360-6
Date
05/16/2002Pubmed ID
12011281DOI
10.1212/wnl.58.9.1360Scopus ID
2-s2.0-0037076472 (requires institutional sign-in at Scopus site) 65 CitationsAbstract
OBJECTIVES: To determine factors affecting the success of radiation therapy (RT) of spinal epidural metastases and patient survival after RT.
DESIGN/METHODS: One hundred thirty-nine male veterans with an initial spinal epidural metastases treated with dexamethasone and RT were evaluated prospectively. Patients were followed until death.
RESULTS: At presentation, 84 patients could walk. After RT, 119 patients walked. The likelihood of regaining ambulation increased if treatment began <12 hours after loss of ambulation and if patients had bladder and bowel function and sacral sensory sparing. Treatment reduced pain levels, and ambulatory patients had less pain compared with nonambulatory patients. Median length of survival was 104 weeks for ambulatory patients and 6 weeks for nonambulatory patients. Mean interval between loss of ambulation and death was 4.0 +/- 0.5 weeks. Recurrent spinal epidural metastases occurred in 8.63% of patients.
CONCLUSIONS: Patients who walked after treatment lived longer, were ambulatory for most of their remaining life, had less pain, and had a lower incidence of depression.
Author List
Zaidat OO, Ruff RLMESH terms used to index this publication - Major topics in bold
AgedAntineoplastic Agents, Hormonal
Depression
Dexamethasone
Epidural Neoplasms
Gait Disorders, Neurologic
Humans
Lung Neoplasms
Male
Neoplasm Recurrence, Local
Pain
Prospective Studies
Prostatic Neoplasms
Recovery of Function
Remission Induction
Survival Rate
Treatment Outcome