Spinal Ewing Sarcoma Debuting with Cord Compression: Have We Discovered the Thread of Ariadne?
| Autor: | Catherine Hayward, Alexandros K. Tsiouris, Nikolaos Zakynthinakis-Kyriakou, Afroditi Karathanasi, Stergios Boussios, Foivos S. Kanellos, Deirdre Cooke, Aikaterini A. Chatziantoniou |
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| Rok vydání: | 2018 |
| Předmět: |
Cancer Research
medicine.medical_specialty Cord medicine.medical_treatment Bone Neoplasms Sarcoma Ewing 03 medical and health sciences 0302 clinical medicine Spinal cord compression medicine Combined Modality Therapy Humans Chemotherapy Spinal Neoplasms business.industry Ewing's sarcoma General Medicine medicine.disease Spinal cord Prognosis Surgery Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Sarcoma business Spinal Cord Compression 030217 neurology & neurosurgery |
| Zdroj: | Anticancer research. 38(10) |
| ISSN: | 1791-7530 |
| Popis: | Ewing's sarcoma (ES) of the spine with cord or radicular compression as an initial sign is infrequent. It is unclear, in alleviating a neurological deficit, whether decompressive laminectomy is preferred over chemotherapy. Herein, a literature review of the treatment approaches to the primary or metastatic ES of the spine has been performed. Collected data included clinical features of the patients, treatment, and outcome. There are reported 69 cases with initial presentation of cord or radicular compression of spinal cord, arising from primary or metastatic ES, treated either with initial chemotherapy and/or radiotherapy (RT) (33.33%, n=23), or decompressive surgery (66.66%, n=46). The median age at diagnosis was 17.95 years old (range=0.06-60), and 38 patients (55.07%) were male. Eighteen (78.26%) were initially treated with chemotherapy combined with RT, whereas 3 (13.04%) were managed with RT alone. One patient (4.35%) received only corticosteroids, while there are not available data for the treatment of another one (4.35%). The remaining 46 patients (66.66%) were initially treated with decompressive surgery. Among them, 40 (57.97%) received postoperative chemotherapy, RT or combined modality therapy, whereas 6 patients (8.69%) were not treated adjuvantly. Sixteen out of 23 patients (69.6%) treated with systemic therapy, and 37 from 46 (80.43%) of those managed with decompressive laminectomy were still alive at a mean follow-up period of 2.11 years (range=0.16-6) and 3.45 years (range=0.16-26.08), respectively. To summarize, spinal resection and reconstruction followed by adjuvant treatment reduce the risk of local recurrence, and improve long-term survival. However, ES of the spine is not a distinct clinical entity and can be either managed with chemotherapy and/or RT, similarly to other localization. |
| Databáze: | OpenAIRE |
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