RESUMEN
BACKGROUND AND OBJECTIVES: Malignant spinal cord compression is an oncologic emergency, unless diagnosed early and treated appropriately, can lead to permanent neurological impairment and compromised quality of life of patients. We analyzed the epidemiology and the effect of common interventions on the outcome in these patients. PATIENTS AND METHODS: We conducted a prospective study of 77 patients in the year 2014 and recorded relevant patient and disease characteristics. All patients received corticosteroids. Eight patients were operated upon, and radiotherapy was delivered in 62 patients. RESULTS: Most of the patients were in the age group of 41-60 years and there was no gender preponderance in patients. Female breast cancer was the most common incident (15.5%) malignancy followed by multiple myeloma, lung, and prostatic carcinoma. Lower dorsal spine was the most common site of compression (35%) followed by lumbar (31%) and mid-dorsal (26%) spine. 70 (91%) patients had cord compression subsequent to bone metastasis while as other patients had leptomeningeal metastasis. In 31 (40%) patients, spinal cord compression was the presenting symptom. Overall, only 26 patients had motor improvement after treatment. CONCLUSION: Grade of power before treatment was predictive of response to treatment and overall outcome of motor or sensory functions. Neurodeficit of more than 10 days duration was associated with poor outcome in neurological function.
RESUMEN
PURPOSE: Tumor bleeding continues to remain a challenge in an oncological setting, and radiotherapy has been studied as a local hemostatic agent. We studied the role of local radiotherapy in controlling bleeding at our center. MATERIALS AND METHODS: We reviewed 25 treated cases (cancer urinary bladder: 12, lung cancer: 5, cervical cancer: 4, uterine cancer: 1, rectal cancer: 2, schwanoma: 1) at our center from March 2008 to December 2010. All patients had either an advanced or recurrent disease. Radiotherapy schedule was either 20 Gray in 5 fractions or 15 Gray in 5 fractions and was delivered with Cobalt 60. RESULTS AND CONCLUSION: Of 25 patients, 22 (88%) responded, and there was complete cessation of bleeding. Both 15 Gray and 20 Gray dose schedule had equal efficacy. Treatment was well tolerated without any intermission. Radiotherapy is a safe and effective option in controlling tumor bleeding.