Spinal epidural tumor in patients with prostate cancer: Clinical and radiographic predictors of response to radiation therapy Journal Article


Authors: Zelefsky, M. J.; Scher, H. I.; Krol, G.; Portenoy, R. K.; Leibel, S. A.; Fuks, Z. Y.
Article Title: Spinal epidural tumor in patients with prostate cancer: Clinical and radiographic predictors of response to radiation therapy
Abstract: The authors retrospectively reviewed 50 episodes of spinal epidural tumor that occurred in 42 patients with metastatic prostate cancer and were treated with external‐beam radiation. Treatment response was evaluated in terms of symptoms, neurologic status, and, in most cases, reduction of tumor on repeat myelography. At the completion of therapy, 92% of treated patients experienced pain relief and 67% had significant to complete improvement on neurologic examination. Thirty days after treatment, repeat myelography was performed in 40 of the 50 cases; compared with the initial findings immediately preceding radiation therapy (RT), the results of 58% of these studies had normalized completely, results were improved in 25%, and the results had not changed in 18%. The presence of a high‐grade compression fracture of the vertebral body was an indicator of poor prognosis for tumor response on repeat myelography. The ability of a patient to walk before treatment and tumor response on repeat myelography were associated significantly with improved outcome of RT and with survival. The authors conclude that RT can effectively palliate epidural lesions from metastatic prostate cancer. The prognosis for the long‐term response to therapy may be indicated by pre‐treatment ambulatory status and posttreatment imaging of the epidural space. Cancer 1992; 70:2319‐2325. Copyright © 1992 American Cancer Society
Keywords: adult; cancer survival; clinical article; aged; aged, 80 and over; survival rate; retrospective studies; cancer radiotherapy; radiation dose; adenocarcinoma; pain; radiotherapy dosage; radiation response; backache; prostate cancer; prostatic neoplasms; probability; spinal cord compression; spinal cord tumor; spinal neoplasms; remission induction; radiation therapy; walking; neurologic examination; paralysis; vertebra fracture; middle age; epidural space; vertebra body; myelography; mobilization; back pain; prognosis; human; male; priority journal; article; support, non-u.s. gov't
Journal Title: Cancer
Volume: 70
Issue: 9
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1992-11-01
Start Page: 2319
End Page: 2325
Language: English
DOI: 10.1002/1097-0142(19921101)70:9<2319::Aid-cncr2820700918>3.0.Co;2-8
PUBMED: 1394060
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 30 July 2019 -- Source: Scopus
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MSK Authors
  1. Zvi Fuks
    427 Fuks
  2. Michael J Zelefsky
    754 Zelefsky
  3. Steven A Leibel
    252 Leibel
  4. George Krol
    86 Krol
  5. Howard Scher
    1130 Scher
  6. Russell K. Portenoy
    165 Portenoy