Marshall L F, Langfitt T W
Cancer. 1977 Nov;40(5):2067-70. doi: 10.1002/1097-0142(197711)40:5<2067::aid-cncr2820400512>3.0.co;2-h.
The effectiveness of combined modality therapy was studied in 29 patients with metastatic extradural spinal tumor who had had a previous diagnosis of malignancy. Dexamethasone was begun upon suspicion of the diagnosis in a dose of 40 mg daily. Following emergency myelography, in all patients without rapid progression, dexamethasone in combination with radiotherapy and chemotherapy, when appropriate, was instituted. If deterioration occurred, decompressive laminectomy was performed. Five ambulatory patients had neurological function preserved and the condition of seven nonambulatory patients was improved to ambulation at discharge with a combination of dexamethasone, radiation therapy, and chemotherapy. These were patients with prostatic carcinoma, Hodgkin's disease, or breast carcinoma. In five patients who failed medical therapy decompressive laminectomy was successful. In patients with metastatic bronchogenic carcinoma, nonsurgical therapy failed and all underwent surgical decompression with a favorable outcome in only two of 10 patients.
对29例先前已诊断为恶性肿瘤的转移性硬膜外脊髓肿瘤患者进行了综合治疗疗效的研究。一旦怀疑诊断，即开始使用地塞米松，剂量为每日40毫克。在急诊脊髓造影后，对于所有病情无快速进展的患者，酌情给予地塞米松联合放疗和化疗。如果病情恶化，则进行减压性椎板切除术。5例能走动的患者神经功能得以保留，7例不能走动的患者通过地塞米松、放射治疗和化疗相结合，在出院时病情改善至能走动。这些患者患有前列腺癌、霍奇金病或乳腺癌。5例药物治疗失败的患者减压性椎板切除术成功。在转移性支气管肺癌患者中，非手术治疗失败，10例患者全部接受了手术减压，仅2例取得了良好效果。
