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Hormonal therapy with external radiation therapy for metastatic spinal cord compression from newly diagnosed prostate cancer

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Although hormonal therapy is effective for treatment of prostate cancer, its effect in the treatment of metastatic spinal cord compression (MSCC) has not been established. The objective of this study was to clarify the efficacy of conservative treatment of MSCC-induced paralysis resulting from prostate cancer for patients without a previous treatment history.

Methods

We reviewed data from 38 patients with MSCC-induced paralysis from newly diagnosed prostate cancer who presented to our service between 1984 and 2010. Conservative treatment consisted of hormonal therapy with external radiation therapy (ERT). Patient demographic data, treatment details, involved spine MRI images, complications, and the course of neurologic recovery were investigated.

Results

Twenty-five patients were treated conservatively. Mean follow-up period was 36.8 months. Sixteen patients (two with Frankel B, 14 with Frankel C) were unable to walk at initial presentation. After initiating conservative treatment, 75 % (12 of 16) of these patients regained the ability to walk within 1 month, 88 % (14 in 16) did so within 3 months, and all non-ambulatory patients did so within 6 months. No one had morbid complications. Four patients who did not regain the ability to walk at 1 month were found to have progressed to paraplegia rapidly, and tended to have severe compression as visualized on MRI, with a delay in the start of treatment in comparison with those who did so within 1 month (21.0 vs. 7.8 days).

Conclusions

Hormonal therapy associated with ERT is an important option for treatment of MSCC resulting from newly diagnosed prostate cancer.

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Acknowledgments

The authors thank Dr Atsushi Seichi, Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan, and Dr Sakae Tanaka, Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Surgical Sciences, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan, for their contributions to data collection and manuscript preparation.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    So Kato, Takahiro Hozumi, Kiyofumi Yamakawa, Akiro Higashikawa, Takahiro Goto & Taiji Kondo

  2. Department of Urology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    Mitsuru Shinohara

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  1. So Kato
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  2. Takahiro Hozumi
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  3. Kiyofumi Yamakawa
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  4. Akiro Higashikawa
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  5. Takahiro Goto
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  7. Taiji Kondo
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Correspondence to So Kato.

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Kato, S., Hozumi, T., Yamakawa, K. et al. Hormonal therapy with external radiation therapy for metastatic spinal cord compression from newly diagnosed prostate cancer. J Orthop Sci 18, 819–825 (2013). https://doi.org/10.1007/s00776-013-0409-y

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  • DOI: https://doi.org/10.1007/s00776-013-0409-y

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