Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
D Andrew Loblaw, Normand J Laperriere

Abstract

To review the literature for malignant extradural spinal cord compression (MSCC), produce evidence-based recommendations based on the criteria used by the Canadian Task Force on the Periodic Health Examination, and make suggestions regarding future research directives. A systematic review of the literature with explicit study selection and evaluation criteria was performed. Primary outcome measure was posttreatment ambulation rate. There is good evidence to support the use of high-dose dexamethasone (96 mg/d), but inconclusive evidence for the use of moderate-dose steroids (16 mg/d) in conjunction with radiotherapy (RT) for the treatment of MSCC. Fair evidence exists for not using steroids in patients who are nonparetic and ambulatory pretreatment, and to give radiation to patients with subclinical spinal cord compression (SCC). The remainder of the recommendations are based on inconclusive evidence: RT alone should be the first-line treatment for ambulatory patients except when there is spinal instability, bony compression, or paraplegia on presentation, in which case surgery should be performed. Either modality can be used for paraparetic patients who are nonambulatory. Postoperative RT should be considered for tumor in resid...Continue Reading

Citations

Apr 5, 2000·Spine·S Oberndorfer, W Grisold
May 26, 2004·Current Treatment Options in Neurology·Robert Cavaliere, David Schiff
Aug 25, 2004·Neurosurgical Focus·Paul KlimoMeic H Schmidt
Sep 8, 2004·Neurosurgical Focus·Iris C Gibbs, Steven D Chang
Feb 3, 2005·Journal of Palliative Medicine·Carolyn Rutter, David E Weissman
Aug 25, 2004·Neurosurgical Focus·Timothy C RykenDaniel K Resnick
Apr 28, 2005·The Journal of Bone and Joint Surgery. British Volume·H C F Bauer
Sep 8, 2005·The Journal of Urology·Joon-Ha OkChristopher P Evans
Oct 11, 2005·Cancer·Peter C GersztenWilliam J Vogel
Nov 10, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ernesto MaranzanoRomina Rossi
Jul 20, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Dirk RadesSteven E Schild
Sep 14, 2007·Acta Oncologica·Elmar ChristianUNKNOWN German Society for Radiation Oncology (DEGRO)
Aug 7, 2008·International Journal of Palliative Nursing·Lawrence Drudge-Coates, Krishnamoorthy Rajbabu
Jul 3, 2010·Journal of Neurosurgery. Spine·Daniel M SciubbaZiya L Gokaslan
Mar 20, 2010·The Journal of Medical Investigation : JMI·Hitoshi Ikushima
Sep 3, 2010·Nature Reviews. Clinical Oncology·Dirk Rades, Janet L Abrahm
Feb 23, 2012·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·D RadesS E Schild
Jul 18, 2014·Neurosurgery·Peter C Gerszten
Jan 31, 2015·Journal of Neurosurgery. Spine·Berkeley G BateJason Weaver
Feb 5, 2015·Continuum : Lifelong Learning in Neurology·Marc C Chamberlain
Mar 18, 2005·Neurosurgical Focus·Peter C GersztenWilliam C Welch
Nov 4, 2005·Journal of Neurosurgery. Spine·Peter C GersztenDavid M Friedland
Mar 4, 2005·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Karl-Ake Jansson, Henrik C F Bauer
Oct 11, 2005·Journal of Neuro-oncology·Melike MutMark E Shaffrey
Dec 14, 2004·Der Internist·J Wierecky, C Bokemeyer
Oct 26, 2006·Cancer·Peter C GersztenWilliam C Welch
Aug 8, 2008·Current Opinion in Supportive and Palliative Care·Krzysztof Siemionow, Isador H Lieberman
Jan 23, 2013·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Einar WaldelandÅslaug Helland
Oct 9, 2015·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Judy PiAli McBride
Sep 25, 2015·The Cochrane Database of Systematic Reviews·Siew Hwa LeeLynn Kilbride
Apr 25, 2017·Clinical Spine Surgery : a Spine Publication·Abhishek KumarCharles G Fisher
Aug 6, 2002·European Journal of Pain : EJP·Tiina SaartoMauri Kouri

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