Kim R Y, Spencer S A, Meredith R F, Weppelmann B, Lee J Y, Smith J W, Salter M M
Department of Radiation Oncology, University of Alabama, Birmingham 35233.
Radiology. 1990 Jul;176(1):279-82. doi: 10.1148/radiology.176.1.2353102.
The treatment results in 59 patients with extradural spinal cord compression (ESCC) who were treated with irradiation between April 1987 and December 1988 were analyzed prospectively. Eighty percent of the patients presented with back pain, which preceded ESCC by an average of 6 weeks. The most common primary tumor was lung cancer (27% of cases), followed by prostate cancer and breast cancer. The prognostic significance of pretreatment motor function, degree of spinal cord block, radiosensitivity of tumor, and radiation dose schedule was determined with multivariate analysis. Only pretreatment motor function was found to be a significant factor in determining functional prognosis (P = .0058). Even with the increasing clinical awareness of ESCC, 78% of the patients in the current series were nonambulatory at presentation. Therefore, computed tomographic myelography or magnetic resonance imaging is recommended for patients with back pain and bone destruction at the site of the complaint if local radiation treatment is not planned.
对1987年4月至1988年12月期间接受放疗的59例硬膜外脊髓压迫（ESCC）患者的治疗结果进行了前瞻性分析。80%的患者出现背痛，平均在ESCC出现前6周。最常见的原发肿瘤是肺癌（占病例的27%），其次是前列腺癌和乳腺癌。通过多变量分析确定了治疗前运动功能、脊髓阻滞程度、肿瘤放射敏感性和放射剂量方案的预后意义。发现只有治疗前运动功能是决定功能预后的重要因素（P = 0.0058）。即使临床对ESCC的认识有所提高，本系列中78%的患者在就诊时无法行走。因此，如果不计划进行局部放射治疗，建议对有背痛且主诉部位有骨质破坏的患者进行计算机断层脊髓造影或磁共振成像检查。
