title: Hormonal therapy with external radiation therapy for metastatic spinal cord compression from newly diagnosed prostate cancer.
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.
authors.affiliation: Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan, skatou-tky@umin.org.
authors.forename: So
authors.initials: S
authors.lastname: Kato
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hozumi
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Yamakawa
authors.forename: Akiro
authors.initials: A
authors.lastname: Higashikawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Goto
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Shinohara
authors.forename: Taiji
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000188:drug therapy* / Q000209:etiology / Q000532:radiotherapy*; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy* / Q000556:secondary
chemical_list: D000726:Androgen Antagonists