PT  - JOURNAL ARTICLE
AU  - DIRK RADES
AU  - STEFAN JANSSEN
AU  - LUKAS KÄSMANN
AU  - LOUISA BOLM
AU  - STEVEN E. SCHILD
TI  - Outcomes After Irradiation of Epidural Spinal Cord Compression Due to Metastatic Thyroid Cancer
DP  - 2016 Apr 01
TA  - Anticancer Research
PG  - 2035--2039
VI  - 36
IP  - 4
4099  - http://ar.iiarjournals.org/content/36/4/2035.short
4100  - http://ar.iiarjournals.org/content/36/4/2035.full
SO  - Anticancer Res2016 Apr 01; 36
AB  - Aim: Epidural spinal cord compression (ESCC) from thyroid cancer is uncommon. This study aimed to contribute to the identification of the most appropriate treatment for these patients. Patients and Methods: Fourteen patients receiving irradiation alone were retrospectively evaluated. Results: Improvement of motor deficits occurred in 36% of patients, further progression was prevented in another 43% (overall response=79%). One of six non-ambulatory patients (17%) became ambulatory. The 12-month rate of freedom from in-field recurrence was 85%; long-course irradiation was superior to short-course irradiation (100% vs. 67%, p=0.11). The 12-month survival rate was 41%. Age <70 years (p=0.007), no other metastases (p=0.007), differentiated cancer (p<0.001), ability to walk (p=0.015), affection of 1-3 vertebrae (p<0.001) and better performance score (p=0.007) were associated with survival. Conclusion: Irradiation resulted in a good response. Neurosurgery appears required for non-ambulatory patients to restore walking ability. Long-course irradiation resulted in excellent long-term freedom from in-field recurrence and appears preferable for patients with favorable survival prognoses.