Spinal cord compression as a primary manifestation of aggressive malignant lymphomas:: Long-term analysis of treatments with radiotherapy, chemotherapy or combined therapy

被引:14
作者
Avilés, A [1 ]
Fernández, R [1 ]
González, JL [1 ]
García, EL [1 ]
Neri, N [1 ]
Talavera, A [1 ]
Diaz-Maqueo, JC [1 ]
机构
[1] Oncol Hosp, Natl Med Ctr, IMSS, Res Unit Oncol Dis, Mexico City 06700, DF, Mexico
关键词
malignant lymphoma; spinal cord compression; chemotherapy; radiotherapy; combined therapy;
D O I
10.1080/10428190290006152
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
A controlled clinical trial evaluated the usefulness of three different therapeutic approaches in the treatment of spinal cord compression (SCC) as primary manifestation of malignant lymphoma with the following end-points: neurological function, event free survival (EFS) and overall survival (OS). Forty-eight patients with SCC as unique manifestation (IE) of malignant lymphoma, were randomly assigned to receive either: radiotherapy (16 patients), chemotherapy (11 patients) or combined therapy (radiotherapy followed by chemotherapy, 21 patients). Although neurological recovery was similar in both groups, EFS and OS were better in the combined therapy arm. Actuarial curves at 10 years showed that EFS was 50% for patients treated with radiotherapy, 46% in the chemotherapy arm and 76% in the combined therapy group. Overall survival was 58, 38 and 76%, respectively, however because of the small number of patients, no statistical differences were observed. Although malignant lymphoma with SCC as primary manifestation could be considered as a localized disease, more patients could have microscopic disseminated disease. The use of combined therapy improves the outcome in this group of patients, and so it should be considered the treatment of choice.
引用
收藏
页码:355 / 359
页数:5
相关论文
共 16 条
[1]  
DIMARCO A, 1989, ACTA ONCOL, V28, P485
[2]   NON-HODGKINS-LYMPHOMA PRESENTING WITH EXTRADURAL SPINAL-CORD COMPRESSION - FUNCTIONAL OUTCOME AND SURVIVAL [J].
EELES, RA ;
OBRIEN, P ;
HORWICH, A ;
BRADA, M .
BRITISH JOURNAL OF CANCER, 1991, 63 (01) :126-129
[3]   METASTATIC EPIDURAL SPINAL-CORD COMPRESSION [J].
GRANT, R ;
PAPADOPOULOS, SM ;
GREENBERG, HS .
NEUROLOGIC CLINICS, 1991, 9 (04) :825-841
[4]   THE USE OF METHYLMETHACRYLATE FOR VERTEBRAL-BODY REPLACEMENT AND ANTERIOR STABILIZATION OF PATHOLOGICAL FRACTURE-DISLOCATIONS OF THE SPINE DUE TO METASTATIC MALIGNANT DISEASE [J].
HARRINGTON, KD .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1981, 63 (01) :36-46
[5]  
LI MH, 1992, ACTA RADIOL, V33, P338
[6]  
LYONS MK, 1992, NEUROSURGERY, V30, P675
[7]   EFFECTIVENESS OF RADIATION-THERAPY WITHOUT SURGERY IN METASTATIC SPINAL-CORD COMPRESSION - FINAL RESULTS FROM A PROSPECTIVE TRIAL [J].
MARANZANO, E ;
LATINI, P .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 32 (04) :959-967
[8]  
MARKRIS A, 1995, CLIN ONCOL, V7, P82
[9]   Non-Hodgkin's lymphoma presenting with spinal cord compression; a clinicopathological review of 25 cases [J].
McDonald, AC ;
Nicoll, JAR ;
Rampling, RP .
EUROPEAN JOURNAL OF CANCER, 2000, 36 (02) :207-213
[10]   STABILIZATION OF THE SPINE AFFECTED BY MALIGNANCY [J].
MILES, J ;
BANKS, AJ ;
DERVIN, E ;
NOORI, Z .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1984, 47 (09) :897-904