New therapy recommendations for spinal complications of cancer
Kentucky study indicates combination of surgery and radiation yields better mobility, lower death rates in patients suffering from spinal cord compression
Cancer patients and their physicians have new answers as they seek the best treatment for the immobilizing trauma of spinal cord compression in metastatic cancer, thanks to Roy Patchell and colleagues at the University of Kentucky.
In this weeks Lancet, Patchells UK research team evaluate traditional surgical and radiation therapy options and conclude that direct decompressive surgery plus postoperative radiotherapy is more effective than either radiotherapy alone or other surgical options.
Metastatic epidural spinal cord compression (MESCC) is a debilitating and common complication of cancer, occurring in 5 to 14 percent of cancer patients. Standard treatment for MESCC consists of corticosteroids and radiotherapy – after which only 50 percent of patients are able to walk. Surgery, in the form of the simple laminectomy procedure used before the availability of radiotherapy, was largely abandoned as a treatment after a small randomized trial published in 1980 demonstrated no benefit of laminectomy alone or in conjunction with radiotherapy. However, the UK trial tested a more modern surgical treatment for MESCC, the direct decompressive surgical resection.
The results of the UK trial are definitive: direct decompressive surgery plus postoperative radiotherapy equal the best chances for regaining mobility in patients with metastatic cancer.
Patchell and his team found compelling results in a randomized, multi-institutional, non-blinded trial assessing the efficacy of surgery and radiotherapy combinations in more than 100 patients with spinal cord compression caused by metastatic cancer. Results were so statistically conclusive in favor of the direct decompressive surgery and radiotherapy combination that researchers halted the study after an interim analysis.
Eighty-four percent of patients who received both surgery and radiotherapy were able to walk after treatment, versus only 57 percent of patients who received only radiation. Patients in the surgery group also retained the ability to walk significantly longer after treatment, and were less dependent upon corticosteroids and opiod analgesics.
Allison Elliott | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...