Analysis of medical treatment of malignant extradural spinal cord tumors

Abstract

So that the medical management of malignant extradural spinal cord tumors could be evaluated 46 patients with known primary malignancy, spinal cord dysfunction and myelographic proof of a compressive lesion were studied. Medical management included radiation therapy in 41 cases and additional hormonal or chemotherapy treatment in some. Only if the patient could ambulate after treatment was the therapy considered a success. There were 14 cases of successful medical treatment. Seven of these patients had repeat myelograms after therapy was finished. These 7 all had normal or greatly improved myelograms. Seven other cases had successful medical treatment but did not have repeat myelogram performed. Conclusions as to the value of medical management are presented. The histology of the tumor appears to be the most important parameter in prognosis. Lymphomas, Ewing's and neuroblastomas have an excellent response to medical management whereas breast tumors only occasionally respond. The authors have no successful cases with lung or kidney neoplasms. They conclude that any evaluation of laminectomy and radiation therapy must take into consideration results of radiation therapy and medical management alone. Copyright © 1966 American Cancer Society