Base de dados : MEDLINE
Pesquisa : C04.588.614.250.803.342 [Categoria DeCS]
Referências encontradas : 506 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 51 ir para página                         

  1 / 506 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28274397
[Au] Autor:Rades D; Veninga T; Conde-Moreno AJ; Cacicedo J; Metz M; Segedin B; Norkus D; Rudat V; Schild SE
[Ad] Endereço:Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. Electronic address: Rades.Dirk@gmx.net.
[Ti] Título:Results of a multicenter study investigating the potential impact of the overall treatment time on outcomes of radiation therapy alone with 5×4 Gy for metastatic epidural spinal cord compression.
[So] Source:Pract Radiat Oncol;7(2):137-144, 2017 Mar - Apr.
[Is] ISSN:1879-8519
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE/OBJECTIVE: A 5×4 Gy program is commonly used for metastatic epidural spinal cord compression (MESCC). It is unclear whether an overall treatment time (OTT) of 5 days (5 consecutive fractions) results in better outcomes than an OTT of 7 days (ie, no irradiation during the weekend). METHODS AND MATERIALS: A total of 111 patients who received 5×4 Gy over 5 consecutive days were retrospectively compared with 277 patients treated with 5×4 Gy over 7 days (no irradiation during the weekend) for effect on motor function, local control of MESCC, and overall survival (OS). Ten further characteristics were evaluated: age, gender, interval tumor diagnosis to MESCC, visceral metastases, other bone metastases, primary tumor type, time developing motor deficits, walking ability, vertebrae involved, and performance status. RESULTS: On multivariate analysis regarding post-radiation therapy motor function, primary tumor type (P = .011) and time developing motor weakness (P < .001) were significant, whereas the OTT did not even achieve significance on univariate analysis (P = .99). On multivariate analysis of local control, visceral metastases (P = .006) were significant. Again, the OTT was not even significant on univariate analysis (P = .81). On multivariate analysis of OS, interval tumor diagnosis to MESCC (P = .015), visceral metastases (P .001), tumor type (P = .003), walking ability (P < .001), and Eastern Cooperative Oncology Group performance score (P < .001) achieved significance. Even on univariate analysis, OTT did not have an effect on OS (P = .79). CONCLUSIONS: Longer OTT did not impair outcomes of irradiation with 5×4 Gy for MESCC; thus, no compensation (for example an additional radiation fraction) is necessary if the radiation treatment is not continued during the weekend.
[Mh] Termos MeSH primário: Fracionamento de Dose
Neoplasias Epidurais/radioterapia
Compressão da Medula Espinal/radioterapia
[Mh] Termos MeSH secundário: Idoso
Neoplasias Epidurais/complicações
Neoplasias Epidurais/secundário
Feminino
Seres Humanos
Masculino
Meia-Idade
Transtornos Motores/diagnóstico
Transtornos Motores/etiologia
Análise Multivariada
Prognóstico
Lesões por Radiação/diagnóstico
Lesões por Radiação/etiologia
Estudos Retrospectivos
Compressão da Medula Espinal/etiologia
Fatores de Tempo
Resultado do Tratamento
Caminhada
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170330
[Lr] Data última revisão:
170330
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE


  2 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28026861
[Au] Autor:Yáñez ML; Miller JJ; Batchelor TT
[Ad] Endereço:Department of Radiation Oncology, Arturo López Pérez Foundation, Santiago, Chile.
[Ti] Título:Diagnosis and treatment of epidural metastases.
[So] Source:Cancer;123(7):1106-1114, 2017 Apr 01.
[Is] ISSN:1097-0142
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Epidural metastases occur in 5% to 10% of cancer patients and represent a neurological emergency. Patients most commonly present with an acute onset of motor weakness, and restoration of neurological function is critically dependent on prompt diagnosis and treatment. This review discusses the clinical, epidemiological, and radiological features associated with epidural metastases and resulting spinal cord compression. Moreover, current treatment paradigms are reviewed. The timely initiation of radiation as well as surgery in select cases is critical for preserving neurological function and achieving local tumor control and pain control. Future studies investigating surgical and radiation treatment for metastatic epidural cord compression are urgently needed. Cancer 2017;123:1106-1114. © 2016 American Cancer Society.
[Mh] Termos MeSH primário: Neoplasias Epidurais/diagnóstico
Neoplasias Epidurais/secundário
Neoplasias Epidurais/terapia
Neoplasias/patologia
[Mh] Termos MeSH secundário: Terapia Combinada/métodos
Neoplasias Epidurais/epidemiologia
Seres Humanos
Imagem por Ressonância Magnética
Prognóstico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161228
[St] Status:MEDLINE
[do] DOI:10.1002/cncr.30521


  3 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27890757
[Au] Autor:Ying GY; Yao Y; Shen F; Ren YC; Chen CM; Zhu YJ
[Ad] Endereço:Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
[Ti] Título:Percutaneous Endoscopic Removal of a Lumbar Epidural Angiolipoma via Interlaminar Approach: A Technical Report.
[So] Source:World Neurosurg;99:59-62, 2017 Mar.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although percutaneous endoscopic technique has been routinely used in the treatment of disk herniation, there are few reports on its application in the management of intraspinal tumors. We present a case report of lumbar epidural angiolipoma that was totally removed by percutaneous endoscopic technique. CASE DESCRIPTION: A 63-year-old man presented with a 4-month history of progressively worsening low back pain. No abnormal neurologic finding was noted on physical examination, and magnetic resonance imaging demonstrated a dorsally located L2-3 epidural lesion, suggestive of a noninfiltrating angiolipoma. During the operation, an 8-mm skin incision was made, and a dilator was bluntly inserted toward the interlaminar space, followed by insertion of a working cannula onto the ligamentum flavum and placement of the endoscope. The interlaminar space was enlarged by resection of part of the lower rim of the right L2 vertebral laminae, and the right side of the interlaminar ligamentum flavum was removed to expose the tumor. The tumor was totally removed piecemeal under endoscopic guidance, and pathologic examination confirmed the diagnosis of angiolipoma. CONCLUSIONS: This report supports the application of percutaneous endoscopic technique in the surgical resection of noninfiltrating extradural lumbar angiolipoma.
[Mh] Termos MeSH primário: Angiolipoma/cirurgia
Neoplasias Epidurais/cirurgia
Vértebras Lombares/cirurgia
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Neuroendoscopia/métodos
[Mh] Termos MeSH secundário: Angiolipoma/patologia
Neoplasias Epidurais/patologia
Seres Humanos
Vértebras Lombares/patologia
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; TECHNICAL REPORT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE


  4 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:27487399
[Au] Autor:Hoes K; Hatanpaa K; Raisanen J; Gluf W
[Ti] Título:Epidural spinal cavernous hemangioma and hybrid vascular subtype.
[So] Source:Clin Neuropathol;35(6):368-374, 2016 Nov/Dec.
[Is] ISSN:0722-5091
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:AIM: To demonstrate less common pathologies of purely epidural spinal tumors that should be considered when noted on MRI prior to surgery. To expand the differential diagnosis of purely epidural spinal tumors and comment on their surgical implications. MATERIAL AND METHODS: We report on two patients from our institution with rare pathology. We also utilized PubMed to concisely review the literature concerning purely epidural vascular lesions akin to the cavernous hemangioma. RESULTS: We describe common clinical presentations, radiographic findings, histopathologic characteristics and treatment algorithms relevant to the rare pure spinal epidural cavernous hemangioma and a newly described compound hemangioma subtype. CONCLUSION: Epidural spinal tumors are relatively common entities, though lesions isolated to the epidural space without origination in the vertebral body or as part of neurologic presentation of metastatic disease, are much less common. Less common pathologies may be missed in the initial differential diagnosis with treatment implications at surgery.
[Mh] Termos MeSH primário: Neoplasias Epidurais/patologia
Hemangioma Cavernoso do Sistema Nervoso Central/patologia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170208
[Lr] Data última revisão:
170208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160804
[St] Status:MEDLINE


  5 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:27481913
[Au] Autor:Iampreechakul P; Siriwimonmas S
[Ad] Endereço:Department of Neurosurgery, Prasat Neurological Institute, Thailand bangruad@hotmail.com.
[Ti] Título:Spontaneous obliteration of spontaneous vertebral arteriovenous fistula associated with fibromuscular dysplasia after partial surgery: A case report.
[So] Source:Interv Neuroradiol;22(6):717-727, 2016 Dec.
[Is] ISSN:2385-2011
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We describe a patient with spontaneous obliteration of spontaneous vertebral arteriovenous fistula (VAVF) associated with fibromuscular dysplasia (FMD) after partial surgery. A 52-year-old hypertensive female woke up one morning with left shoulder pain and weakness of the left upper extremity. A few days later, she developed left-sided audible bruit. She was treated for left frozen shoulder and supportive treatment for audible bruit for four years. She was referred from her general physician to a neurosurgeon because of left arm weakness. Physical examination showed signs of cervical radiculomyelopathy. Magnetic resonance imaging (MRI) showed an extradural mass on the left side of the cervical spinal canal from level C2 to C6. Provisional diagnosis was epidural vascular tumour. Laminectomy and partial removal of the mass was performed at level C5 to C6. Pathological report revealed suspected vascular malformation. Postoperative MRI showed thrombosed epidural vascular structure. Angiography showed dysplastic changes of both vertebral arteries representing FMD with VAVF of the left vertebral artery at level C1-C2. Two years after surgery, follow-up MRI demonstrated complete spontaneous resolution of the large thrombosed epidural vein. Disappearance of her audible bruit immediately after surgery and gradual improvement of her cervical radiculomyelopathy were observed after two years of clinical follow-up. From the literature, we found another 11 patients with 12 VAVFs who had spontaneous obliteration or cure of their fistulas. In the present case, spontaneous obliteration of the fistula seems to correlate with surgery inducing closure of the epidural venous exit leading to thrombosis of the enlarged epidural draining vein.
[Mh] Termos MeSH primário: Fístula Arteriovenosa/etiologia
Fístula Arteriovenosa/cirurgia
Displasia Fibromuscular/complicações
Displasia Fibromuscular/cirurgia
Procedimentos Neurocirúrgicos/métodos
Artéria Vertebral/cirurgia
[Mh] Termos MeSH secundário: Fístula Arteriovenosa/diagnóstico por imagem
Angiografia Cerebral
Neoplasias Epidurais/cirurgia
Feminino
Seres Humanos
Hipertensão/complicações
Angiografia por Ressonância Magnética
Imagem por Ressonância Magnética
Meia-Idade
Complicações Pós-Operatórias/terapia
Remissão Espontânea
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170827
[Lr] Data última revisão:
170827
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160803
[St] Status:MEDLINE


  6 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:27444294
[Au] Autor:Peter S; Matevz S; Borut P
[Ad] Endereço:Department of Neurosurgery, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia. spazzapanpeter@yahoo.it.
[Ti] Título:Spinal dumbbell lipoblastoma: a case-based update.
[So] Source:Childs Nerv Syst;32(11):2069-2073, 2016 Nov.
[Is] ISSN:1433-0350
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Lipoblastomas are benign tumors that arise from the proliferation of fetal adipose tissue. They are frequently found in the extremities, in the head, and in the neck. Dumbbell conformation (which refers to epidural tumors with extraspinal extension) has been described in only seven lipoblastoma cases so far. CASE REPORT: We describe an 11-month-old patient with a large mediastinal dumbbell lipoblastoma. The mass was excised, but it recurred 1 year later when the MRI showed also multiple pleural lipoblastomatous lesions, thus establishing the diagnosis of lipoblastomatosis. The tumor has been removed with a second surgical procedure. CONCLUSION: Radical excision of lipoblastomas is the gold standard but is not always possible to achieve. Residual lesions can be managed conservatively, on the basis of the benign nature of the tumor and of its potential maturation to normal fat. Recurrence of lipoblastoma appears in 15 % of non-radical excisions but has not yet been described in the form of lipoblastomatosis. A second surgery is indicated if the tumor mass reaches large dimensions, if it increases in size, and if it threatens the functionality of vital organs such as the spinal cord.
[Mh] Termos MeSH primário: Neoplasias Epidurais/patologia
Lipoblastoma/patologia
Recidiva Local de Neoplasia/patologia
[Mh] Termos MeSH secundário: Neoplasias Epidurais/cirurgia
Feminino
Seres Humanos
Lactente
Lipoblastoma/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160723
[St] Status:MEDLINE


  7 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27368507
[Au] Autor:Ben Nsir A; Hadhri R; Kilani M; Chabaane M; Darmoul M; Hattab N
[Ad] Endereço:Department of Neurosurgery, Fattouma Bourguiba University Hospital, The University of Medicine of Monastir, Monastir, Tunisia. Electronic address: atefbn@hotmail.fr.
[Ti] Título:Epidural Venous Angioma Presenting with Spinal Cord Compression in a 42-Year-Old Woman with Previous History of Ovarian Malignancy.
[So] Source:World Neurosurg;93:488.e5-7, 2016 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Venous angioma is an extremely rare vascular malformation of the epidural space. To the best of our knowledge, only 5 cases have been documented to date and none has been reported in the setting of a previous malignancy. CASE DESCRIPTION: We report the case of a 42-year-old woman with a previous history of ovarian cancer, treated by surgery plus chemotherapy; who presented with signs of spinal cord compression for 3 weeks. Magnetic resonance imaging showed an intensely enhancing epidural mass at the T2-T6 level causing major spinal cord compression, for which urgent surgery was indicated. During surgery, the tumor was extremely hemorrhagic and the hemostasis was hazardous. Blood loss was estimated at 1.5 L, causing hemodynamic instability and requiring intensive resuscitation with fluids and blood transfusions. Gross total resection was achieved and the pathologic examination confirmed the diagnosis of venous angioma. The patient recovered quickly postoperatively and was able to walk independently within 2 weeks of starting intensive rehabilitation. She was symptom free with no clinical or radiologic evidence of recurrence at 1 year follow-up. CONCLUSIONS: Venous angioma should be included in the differential diagnosis of spinal epidural masses even in case of previous malignancy. Subtle imaging features should alert clinicians to this rare yet potentially life-threatening condition. Surgery remains the cornerstone of the treatment and can result in remarkable recovery.
[Mh] Termos MeSH primário: Angioma Venoso do Sistema Nervoso Central/cirurgia
Neoplasias Epidurais/secundário
Neoplasias Epidurais/cirurgia
Neoplasias Ovarianas/patologia
Neoplasias Ovarianas/cirurgia
Compressão da Medula Espinal/prevenção & controle
[Mh] Termos MeSH secundário: Angioma Venoso do Sistema Nervoso Central/complicações
Angioma Venoso do Sistema Nervoso Central/patologia
Diagnóstico Diferencial
Neoplasias Epidurais/patologia
Feminino
Seres Humanos
Meia-Idade
Compressão da Medula Espinal/diagnóstico por imagem
Compressão da Medula Espinal/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160703
[St] Status:MEDLINE


  8 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27262734
[Au] Autor:Toto RL; Zuckerbraun NS; Manole MD
[Ad] Endereço:Pediatric Residency Program, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
[Ti] Título:Neck Pain in a 12-Year-Old Female: An Unusual Diagnosis.
[So] Source:J Emerg Med;51(2):e15-8, 2016 Aug.
[Is] ISSN:0736-4679
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Neck pain in the pediatric population has a broad differential diagnosis, ranging from benign to imminently life-threatening causes. Trauma and infection represent the most common etiologies of pediatric neck pain in the pediatric emergency department (PED) setting. Malignancy, though a rare cause of pediatric neck pain, is important to consider in patients with acquired torticollis or focal neurologic signs. CASE REPORT: We describe the case of a previously healthy 12-year-old female who presented to the PED with neck pain radiating down her upper extremities. The physical examination revealed diminished strength in her upper extremities compared to her lower extremities. Further evaluation revealed lymphadenopathy in the cervical and mediastinal areas and an epidural tumor in the cervical spinal column. The ultimate diagnosis was Hodgkin lymphoma presenting in an unusual manner with cervical spinal cord compression. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Neck pain is a common chief complaint among pediatric patients in the emergency setting. This case of spinal cord compression caused by malignancy illustrates the necessity of detailed spinal imaging in patients with neck pain and "red flag" signs, including but not limited to an abnormal neurologic examination.
[Mh] Termos MeSH primário: Vértebras Cervicais
Neoplasias Epidurais/complicações
Doença de Hodgkin/complicações
Cervicalgia/etiologia
[Mh] Termos MeSH secundário: Criança
Diagnóstico Diferencial
Neoplasias Epidurais/diagnóstico
Feminino
Doença de Hodgkin/diagnóstico
Seres Humanos
Compressão da Medula Espinal/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160606
[St] Status:MEDLINE


  9 / 506 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27221016
[Au] Autor:Welsh L; Binder W; Miller ES
[Ad] Endereço:Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
[Ti] Título:Unsteady Gait and Dizziness.
[So] Source:J Emerg Med;50(6):887-90, 2016 Jun.
[Is] ISSN:0736-4679
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Tontura/etiologia
Transtornos Neurológicos da Marcha/etiologia
Compressão da Medula Espinal/diagnóstico
[Mh] Termos MeSH secundário: Acidentes por Quedas
Anticonvulsivantes/farmacologia
Anticonvulsivantes/uso terapêutico
Medula Cervical/anormalidades
Clonazepam/farmacologia
Clonazepam/uso terapêutico
Neoplasias Epidurais/complicações
Neoplasias Epidurais/fisiopatologia
Neoplasias Epidurais/cirurgia
Seres Humanos
Laminectomia
Imagem por Ressonância Magnética/métodos
Masculino
Mianserina/análogos & derivados
Mianserina/farmacologia
Mianserina/uso terapêutico
Meia-Idade
Oxicodona/farmacologia
Oxicodona/uso terapêutico
Compressão da Medula Espinal/fisiopatologia
Compressão da Medula Espinal/cirurgia
Triazinas/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Triazines); 250PJI13LM (Mianserin); 5PE9FDE8GB (Clonazepam); A051Q2099Q (mirtazapine); CD35PMG570 (Oxycodone); U3H27498KS (lamotrigine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160526
[St] Status:MEDLINE


  10 / 506 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27112529
[Au] Autor:Spratt DE; Osborne JR; Zumsteg ZS; Rebeiz K; Leeman J; Rivera A; Morris MJ; Zelefsky MJ
[Ad] Endereço:Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
[Ti] Título:Radium-223 outcomes after multiple lines of metastatic castration-resistant prostate cancer therapy in clinical practice: implication of pre-treatment spinal epidural disease.
[So] Source:Prostate Cancer Prostatic Dis;19(3):271-6, 2016 09.
[Is] ISSN:1476-5608
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Magnetic resonance imaging (MRI) is not routinely performed before initiating radium-223 to document spinal epidural disease. However, radium-223 decays to form α-particles with very short path lengths that may not reach the epidural space. Herein, we investigate the impact of baseline spinal epidural disease on metastatic castration-resistant prostate cancer (mCRPC) patients treated with radium-223. METHODS: Between October 2013 to December 2014, 41 consecutive mCRPC patients at a large tertiary cancer center were prescribed radium-223 as part of standard of care. 29% of patients had pre-treatment epidural disease (posMRI), 27% had no epidural disease (negMRI), and 44% did not have a baseline MRI (noMRI). All patients had post-treatment spinal imaging. Actuarial survival times were calculated for overall survival (OS), spinal axis radiographic progression-free survival (spinePFS) and epidural progression-free survival (epiPFS) from time of first radium-223 treatment. RESULTS: For patients with posMRI (n=12), noMRI (n=18) and negMRI (n=11) cumulative rates of development or worsening of epidural disease and/or high-grade cord compression at time of last follow-up were 83%, 44% and 9%, respectively (P=0.001). For the posMRI, noMRI and negMRI groups the median OS was 6.3 months, 12.6 months and not reached (P=0.01), the median spinePFS was 3.2 months, 4.8 months and not reached (P=0.01), and the median epiPFS was 3.2 months, 10.4 months and not reached (P=0.001). Completing less than six cycles of radium-223 was significantly associated with worse OS (P<0.0001), spinePFS (P=0.007) and epiPFS (P=0.01). Greater than or equal to twenty osseous lesions pre-treatment was significantly associated with worse spinePFS (P=0.001) and epiPFS (P=0.03). CONCLUSIONS: In a heavily pre-treated small cohort, patients with baseline epidural disease frequently progressed to spinal cord compression and early cessation of radium-223 therapy. Studies are needed to determine the optimal timing of radium-223 with other mCRPC therapies given the predilection for epidural disease and treatment failure after multiple prior lines of mCRPC therapy.
[Mh] Termos MeSH primário: Braquiterapia
Neoplasias de Próstata Resistentes à Castração/mortalidade
Neoplasias de Próstata Resistentes à Castração/radioterapia
Rádio (Elemento)/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Terapia Combinada
Progressão da Doença
Neoplasias Epidurais/diagnóstico
Neoplasias Epidurais/secundário
Seguimentos
Seres Humanos
Estimativa de Kaplan-Meier
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Metástase Neoplásica
Estadiamento de Neoplasias
Prognóstico
Neoplasias de Próstata Resistentes à Castração/diagnóstico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
W90AYD6R3Q (Radium)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160427
[St] Status:MEDLINE
[do] DOI:10.1038/pcan.2016.14



página 1 de 51 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde