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1.
J Neurooncol ; 1(1): 21-8, 1983.
Article in English | MEDLINE | ID: mdl-6678303

ABSTRACT

The results of 51 patients with metastatic spinal cord compression were analyzed. There were seven paralyzed patients, three received radiotherapy (RT) alone and four received laminectomy (L) + RT. No patient regained any motor function. Of six ambulatory patients, half received RT and half L + RT. All remained ambulatory after the treatment. Of 38 paraparetic patients, 20 underwent L + RT. Their complete, partial and nonresponse (CR, PR, NR respectively) rates were 25%, 60% and 15%, respectively. This result was clearly better than 18 other patients treated by RT alone of which only 22% regained ambulation (CR = 22%) while 67% were NR and 11% had a PR. In this series combined modality therapy appears better in paraparetic patients. Five patients with radiosensitive tumors all had CR/PR whether treated by RT or L + RT. Patients with epithelial tumors treated by L + RT had a PR (CR + PR) of 71% while RT alone gave only 25%. On the basis of this analysis we conclude: (1) ambulatory patients respond satisfactorily to RT alone; (2) paraparetic patients with radiosensitive tumors do well with RT alone while such patients with epithelial tumors merit L + RT; but (3) paraplegic patients rarely benefit from either modality; (4) pain control appears a useful measure of minimally adequate radiation dose in individual patients.


Subject(s)
Spinal Cord Compression/therapy , Spinal Neoplasms/secondary , Combined Modality Therapy , Epidural Space , Female , Humans , Laminectomy , Male , Middle Aged , Paralysis/etiology , Paralysis/therapy , Prognosis , Spinal Cord Compression/etiology , Spinal Neoplasms/complications , Spinal Neoplasms/radiotherapy
2.
Cancer ; 45(4): 703-8, 1980 Feb 15.
Article in English | MEDLINE | ID: mdl-6153563

ABSTRACT

Six patients with unresectable carcinoma of the esophagus received a combined course of external radiation therapy (1000 rads in four fractions in four days commencing on day 2) combined with constant infusional 5-fluorouracil (20 mg/kg every 24 hours for five days beginning on day 1). This program was repeated every other week to give a total x-ray dose of 6000 rads. This regimen has been well-tolerated by the majority of the patients and resulted in a complete response rate within the x-ray treatment field of 83% (5/6). All patients who showed a demonstrable systemic response to 5-fluorouracil reached complete response. The median survival has not yet been reached at six months with post-treatment survivors alive and without disease (four patients) at one, six, nine, and 22 months. Our previous median survival by x-ray therapy alone was 4 1/2 months. Toxicity consists primarily of hematologic suppression at a subclinical level. Although the length of therapy is substantial (11 weeks), the program appears tolerable and is capable of inducing long-term remissions. The program is currently being studied for dose escalation because neither local nor systemic side effects of a dose-limiting nature have been observed at 20 mg/kg 5-FU.


Subject(s)
Esophageal Neoplasms/drug therapy , Fluorouracil/administration & dosage , Bone Marrow/drug effects , Drug Tolerance , Esophageal Neoplasms/radiotherapy , Fluorouracil/adverse effects , Fluorouracil/therapeutic use , Humans , Infusions, Parenteral , Male , Palliative Care , Radiation Tolerance , Radiotherapy, High-Energy , Remission, Spontaneous
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