spinal cord compression in patients with sarcoma Ppt Powerpoint Presentation slides Ofer Merimsky Medical Slideshow Oncologic emergency : Malignant spinal cord compression

spinal cord compression in patients with sarcoma

Rating :

Rate It:

Send This

Download

Comment

Favourite

more

Post To:

Facebook

Twitter

Digg

Delicious

more share options

There is no comments now for this Slide.

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

Notes

Show Notes

Slide 1 :

Radiation Therapy for Spinal Cord Compression in Patients with Soft Tissue Sarcoma Ofer Merimsky, MD, Yehuda Kollender, MD, Felix Bokstein, MD, Josephine Issakov, MD, Gideon Flusser, MD, Moshe J. Inbar, MD, Isaac Meller, MD, and Jacob Bickels, MDUnit of Bone and Soft Tissue Oncology, Department of Oncology, the National Unit of Orthopedic Oncology, Departments of Pathology, Radiology, The Tel-Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Slide 2 :

Introduction Spinal metastases of soft tissue sarcoma occur rarely. Literature data on the therapeutic approach towards spinal cord or root involvement by metastatic STS is limited to case reports or small surgical series. While wide resection is warranted for best chance of local control of primary spinal sarcoma, its feasibility and success are limited in cases of metastatic STS to the spine. A second limitation in treating SpCC in patients with STS is the dose of radiation therapy (RT) that can be given. While 65-70 Gy can be safely given for most of the primary limb STS, only 45 Gy can be safely given to spinal metastases. The clinical meaning is that RT in patients with STS will never be able to eradicate the tumor, and the tumor response may be very modest.

Slide 3 :

Data & Results Chemotherapy was not prescribed for palliation of spinal cord compression but only if a systemic treatment was indicated. Steroids and analgetics were always administered. Radiation therapy was considered for unresectable cases and for adjunctive treatment after surgical intervention in all the cases. Radiation therapy (RT) was delivered by 60C0 or LINAC 8MV beam via a postero-anterior portal, in all the patients with a cord compression below C4 level. The target volume included the affected levels plus two extra vertebrae located cranially and caudally. Lateral margins were one centimeter laterally to the transverse process on each side. The prescribed dose was 30 Gy by 10 fractions over 12 days to a depth of 5-7 cm. In patients with cord compression at C4 or above, 2 opposed lateral fields were used, with 1 cm margins anteriorly and posteriorly. The prescribed midplane dose was 30 Gy by 10 fractions over 12 days to a similar target volume. The effect of treatment was evaluated on a clinical basis and not on radiological measurements of tumor size, because of the difficulty and complexity of such assessment.

Slide 4 :

Conclusions Spinal cord compression occurs in 3% of patients with soft tissue sarcoma, and should be suspected in the presence of a new back pain. The median post-SpCC survival of 6 months certainly permits an aggressive approach, which should be tailored in every case by a multidisciplinary team. RT up to 45 cGy may achieve palliation of signs and symptoms.

	merimsky@zahav.net.il 1 Years ago. Category: Surgery

Tags:	Surgery

Embed:
121 Views, 0 favourite
PowerPoint Presentation on spinal cord compression in patients with sarcoma or PowerPoint Presentat more PowerPoint Presentation on spinal cord compression in patients with sarcoma or PowerPoint Presentation on spinal cord compression less

SWINE Flu

Why do women live longer then men? Humor

History of Medicine

Yoga and Medicine

How to be a Successful Interventional Fellow size 50 MB

Cardiac Pathology

Hypertension: New Concepts, Guidelines, and Clinical Management

Diabetes Pathology

Medical Powerpoint Templates
(20% Dicsount For Student/Faculty)