Combination chemotherapy and radiation therapy. The medical management of epidural spinal cord compression from testicular cancer.
Radiation and surgery are the mainstays of treatment for epidural spinal cord compression. There are reports in the literature, however, in which the use of chemotherapy alone or in combination with radiation and surgery has resulted in improved patient response. We present two patients with spinal cord compression from testicular cancer who developed progressive paraplegias that were successfully reversed with combination chemotherapy, steroids, and radiotherapy. In one case, the patient was unable to receive more than 600 rad (6 Gy) of radiation and his improvement was clearly related to the chemotherapy he received. In treating tumors causing spinal cord compression that are thought to be chemosensitive, one should consider adding chemotherapy to radiation or using chemotherapy alone if the options of surgery or radiation are not available.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D009192:Myelography; D009919:Orchiectomy; D010264:Paraplegia / Q000209:etiology; D013117:Spinal Cord Compression / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery; D013736:Testicular Neoplasms / Q000150:complications
D000305:Adrenal Cortex Hormones