Endo Shogo, Hida Kazutoshi, Yano Shunsuke, Ito Masaki, Yamaguchi Shigeru, Kashiwazaki Daina, Kinoshita Rumiko, Shirato Hiroki, Iwasaki Yoshinobu
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan.
No Shinkei Geka. 2008 Apr;36(4):345-9.
Intramedurally spinal cord metastasis (ISCM) tends to be seen in the end period of the malignant tumor, so it is important to choose a therapeutic method regarding the QOL (quality of life) of the patient. In this study, we reported three cases of ISCM treated by radiation therapy alone, and demonstrated the utility of this therapeutic procedure.
From 2005 to 2006, 3 cases of ISCM underwent radiotherapy in our institution. The mean age of the patients was 64.0 years old, and all patients were men, having lung carcinoma as their primary lesions. The lesions were located at the cervical cord in one case and the conus medullaris in the other two cases. They were treated by radiotherapy at the department of radiology in our institute.
The tumor size and intramedullary high signal area on MR images after the radiotherapy were reduced in all patients. During the clinical course, neurological symptoms were improved in two patients, and progression of the symptoms was stopped in one patient. All of the patients obtained a better ADL due to the radiotherapy.
Radiotherapy has an advantage over surgical treatment in that it involves less invasion. The treatment brought improvements of clinical symptoms and radiological findings in the patients with ISCM. So, radiotherapy could be used as one of the major treatments for patients with ISCM who desire a better QOL after treatment.
髓内脊髓转移瘤(ISCM)多见于恶性肿瘤晚期,因此选择一种考虑患者生活质量(QOL)的治疗方法很重要。在本研究中,我们报告了3例仅接受放射治疗的ISCM病例,并证明了该治疗方法的有效性。
2005年至2006年,我院有3例ISCM患者接受了放射治疗。患者的平均年龄为64.0岁,均为男性,原发灶均为肺癌。病变位于颈髓1例,圆锥2例。均在我院放射科接受放射治疗。
所有患者放疗后MRI图像上的肿瘤大小和髓内高信号区均减小。在临床过程中,2例患者神经症状改善,1例患者症状进展停止。所有患者因放疗后日常生活活动能力(ADL)均有改善。
放射治疗与手术治疗相比具有侵袭性小的优势。该治疗使ISCM患者的临床症状和影像学表现得到改善。因此,对于希望治疗后获得更好生活质量的ISCM患者,放射治疗可作为主要治疗方法之一。