Klarskov Niels
Urologisk Sektion, Amtssygehuset i Glostrup.
Ugeskr Laeger. 2003 May 12;165(20):2085-8.
The aim of the study was to describe symptomatology and prognosis in patients with spinal cord compression and prostate cancer.
The material was retrospective and included patients from 1.1.1996 to 31.12.2000 with compression of the medulla, dura or intraspinal roots. Data collection was concluded on 30.6.2001.
Seven patients had the cancer diagnosis at the time of the intraspinal compression. The most frequent debut-symptom was acceleration of pain, two thirds had neuropathic pain, and three patients were free of pain. Paresis was present in 23 patients and 18 had sensory symptoms. External irradiation was given to 29 patients, three had a neurosurgical procedure and irradiation and two patients had just endocrine manipulation. The treatment result was good or moderately good on pain in three fourths of the patients, and on the neurological symptoms in two thirds. Eight patients had recurrence. Median survival was three months for patients with hormone resistant progression and two years for those patients, who got their cancer diagnosis in connection with the intraspinal compression.
Rapid acceleration of pain is an early symptom of intraspinal compression. Morphine-resistant pain or neuropathic pain and neurologic symptoms are typical findings, but none of the symptoms are obligatory. Early acute treatment may give good recovery and the survival is comparable with the survival of patients whose illnesses are in the same stadium but who do not suffer from intraspinal compression.
本研究旨在描述脊髓受压合并前列腺癌患者的症状学及预后情况。
本研究为回顾性研究,纳入了1996年1月1日至2000年12月31日期间出现延髓、硬脊膜或脊髓内神经根受压的患者。数据收集于2001年6月30日结束。
7例患者在脊髓受压时被诊断患有癌症。最常见的首发症状是疼痛加剧,三分之二的患者有神经性疼痛,3例患者无疼痛症状。23例患者出现轻瘫,18例有感觉症状。29例患者接受了外照射,3例接受了神经外科手术及照射,2例仅接受了内分泌治疗。四分之三的患者疼痛治疗效果良好或中等良好,三分之二的患者神经症状治疗效果良好。8例患者复发。激素抵抗性进展患者的中位生存期为3个月,在脊髓受压时被诊断患有癌症的患者中位生存期为2年。
疼痛迅速加剧是脊髓受压的早期症状。吗啡抵抗性疼痛或神经性疼痛以及神经症状是典型表现,但并非所有症状都会出现。早期积极治疗可能会带来良好的恢复,其生存期与处于相同分期但未发生脊髓受压的患者相当。