title: Clinical outcome in patients with intramedullary spinal cord metastases from lung cancer.
abstract: Intramedullary spinal cord metastases (ISCM) are uncommon and present with rapidly progressing neurological deficits. The objective of this study was to determine the rate, duration of neurological response and survival after radiation therapy. We have retrospectively reviewed the clinical outcome of six cases with a diagnosis of ISCM from primary lung cancer, non-small cell (NSCLC) (n=3) and small cell (SCLC) (n=3). Total radiation dose ranged from 27 Gy/5 fr to 40 Gy/20 fr. Ambulation was preserved in 3 patients and partially recovered in one. Five out of the six patients (83%) showed improvement in neurological signs/symptoms with a mean duration of 17.2 days (max: 40 days; min: 6 days). Median survival time was 5 months (confidence interval (CI) 95%: 0-12) for NSCLC and 5 months (CI 95%: 4-6) for SCLC. Although radiation response rate is high, the interval free of neurological progression is very short. A therapeutic approach should be considered for each individual.
authors.affiliation: Department of Radiation Oncology, Institute of Hematology and Oncology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. cconill@clinic.ub.es
authors.forename: C
authors.initials: C
authors.lastname: Conill
authors.forename: J
authors.initials: J
authors.lastname: Marruecos
authors.forename: E
authors.initials: E
authors.lastname: Verger
authors.forename: J
authors.initials: J
authors.lastname: Berenguer
authors.forename: F
authors.initials: F
authors.lastname: Lomeña
authors.forename: J
authors.initials: J
authors.lastname: Domingo-Domènech
authors.forename: J J
authors.initials: JJ
authors.lastname: Grau
authors.forename: F
authors.initials: F
authors.lastname: Casas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D018288:Carcinoma, Small Cell / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D002574:Cervical Vertebrae; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010264:Paraplegia / Q000209:etiology; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000532:radiotherapy; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000556:secondary*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome