共查询到19条相似文献,搜索用时 640 毫秒
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恶性脊髓压迫症(MSCC)是恶性肿瘤晚期常见的肿瘤急症.MSCC在所有肿瘤中均可发生,常见于乳腺癌、前列腺癌、肺癌.该症的特点是起病急、病程短、发展迅速,如果得不到及时诊治,常发生不可逆的神经损害,严重影响患者的生活质量.因此早期识别、及时恰当的治疗至关重要.目前关于MSCC的病因、发病机制、临床表现和诊断、治疗方面虽... 相似文献
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乳腺癌骨转移和骨相关疾病临床诊疗专家共识(2008版) 总被引:2,自引:0,他引:2
乳腺癌骨转移和骨相关疾病临床诊疗专家组 《中华肿瘤杂志》2009,31(2)
乳腺癌骨转移在复发转移乳腺癌中的发生率为65%~75%.乳腺癌远处转移中,首发症状为骨转移者占27%~50%.骨痛、骨损伤、骨相关事件(skeletal related event,SRE)的发生及生活质量的降低是乳腺癌骨转移的常见并发症.SHE是指在临床试验中表明双膦酸盐类药物治疗失败的研究观察终点,一般定义为骨痛加剧或出现新的骨痛、病理性骨折、椎体压缩或变形、脊髓压迫、骨放疗、骨转移病灶进展及高钙血症等事件,是影响患者自主活动能力和生活质量的主要因素[1-3]. 相似文献
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脊柱是晚期癌症患者常见的转移部位,临床主要表现为局部及胸腹部放射性疼痛,压迫脊髓后可致截瘫及大小便功能障碍。放射治疗是有效的治疗方法。回顾分析我院诊治的91例临床病例资料,结果总结报道如下。 相似文献
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脊柱转移性肿瘤的手术治疗 总被引:1,自引:0,他引:1
脊柱是恶性肿瘤发生骨转移最常见的部位[1], 胸腰椎多见,其次为颈椎和骶椎.脊柱转移瘤引起的疼痛和脊髓受压导致的截瘫严重降低了患者的生存质量.近年来,脊柱外科技术的进步和对原发肿瘤诊治水平的提高,在一定程度上延长了患者生存时间,提高了生存质量.对脊柱转移瘤的治疗观念、对策也在发生转变,现就近年来脊柱外科手术治疗脊柱转移瘤的相关研究综述如下. 相似文献
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目的:在偶发的和计划的硬膜内脊髓肿瘤手术中使用纤维蛋白黏合剂可减少并发症的发生,但计划性开颅手术未要求使用纤维蛋白黏合剂.评估纤维蛋白黏合剂对原发性硬膜内脊髓肿瘤手术临床疗效的影响.方法:选取自2012年1月至2015年1月就诊于我院的500名原发性硬膜内脊髓肿瘤且无硬膜外伴发症患者为研究对象,按手术中纤维蛋白黏合剂的使用情况,分为对照组(未使用纤维蛋白黏合剂,100人)和实验组(使用纤维蛋白黏合剂,400人).评估主要指标是并发症,次要指标是住院时间、手术后1天以及2天身体最高体温和引流液量.结果:28人发生并发症(对照组7人,实验组21人,P=0.50).手术后行走状态和手术时间是并发症发生的主要影响因素,纤维蛋白黏合剂的使用不是手术结果的影响因素.结论:原发性硬膜内脊髓肿瘤手术后并发症的发生与纤维蛋白黏合剂的使用无相关性.手术中使用纤维蛋白黏合剂可根据手术情况确定. 相似文献
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Nikolaou M Koumpou M Mylonakis N Karabelis A Pectasides D Kosmas C 《Cancer investigation》2006,24(1):46-49
Intramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic malignancy. Lung cancer represents the most common solid tumor associated with the development of ISCM.
We describe a 47-year-old female with atypical small cell lung cancer (SCLC) developing ISCM. After a thoracoscopic biopsy she was treated with combination chemotherapy consolidated by mediastinal radiotherapy leading to complete remission. Three months later, she developed a Brown-Sequard syndrome and an MRI scan revealed ISCM at the T10-T12 levels, and secondary brain lesions. Despite treatment with steroids and thoracic spine/brain radiotherapy, no recovery of her motor function was seen and she died 4 months later due to progressive disease in the CNS.
The present case, adds to the existing list of ISCM cases reported so far for lung cancer, undermine the ominous prognosis and limited treatment options available, and an extensive literature overview and discussion of similar cases is provided. 相似文献
We describe a 47-year-old female with atypical small cell lung cancer (SCLC) developing ISCM. After a thoracoscopic biopsy she was treated with combination chemotherapy consolidated by mediastinal radiotherapy leading to complete remission. Three months later, she developed a Brown-Sequard syndrome and an MRI scan revealed ISCM at the T10-T12 levels, and secondary brain lesions. Despite treatment with steroids and thoracic spine/brain radiotherapy, no recovery of her motor function was seen and she died 4 months later due to progressive disease in the CNS.
The present case, adds to the existing list of ISCM cases reported so far for lung cancer, undermine the ominous prognosis and limited treatment options available, and an extensive literature overview and discussion of similar cases is provided. 相似文献
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Kosmas C Koumpou M Nikolaou M Katselis J Soukouli G Markoutsaki N Kostopoulou V Gaglia A Mylonakis N Karabelis A Pectasides D 《Journal of neuro-oncology》2005,71(1):67-72
Intramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic cancer. Breast cancer represents one of the most common solid tumors associated with the development of ISCM at rather advanced stages of disease. In the present report we describe four new cases with advanced breast cancer developing ISCM. All cases presented herein indicated that ISCM is a late manifestation of disseminated breast cancer. Three of these patients had been treated for approximately 1–3 years for metastatic disease. Once ISCM developed, concurrent asymptomatic brain metastases were detected in one case, concurrent symptomatic brain disease (cerebellar) was present at the time of cervical ISCM diagnosis in another patient, and in another case, ISCM developed metachronously at 18 months after the diagnosis of symptomatic brain metastases treated by whole brain radiotherapy. One of these cases had brain metastases at presentation, while at relapse developed leptomeningeal carcinomatosis treated successfully, but followed shortly, as a terminal event, by ISCM and parenchymal brain recurrence.All but one patient experienced a rather rapidly evolving disease course leading to death after 2–5 months from widespread neuraxis dissemination of their cancer, while one patient is still alive 6 months after the diagnosis of ISCM. All four cases, added to the list of the anecdotally reported cases of ISCM after breast cancer, undermine the ominous prognosis and limited treatment options available for this disease manifestation, and an extensive literature review and discussion of similar cases is provided. 相似文献
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Kosmas C Malamos NA Stefanou S Gregoriou A Tsavaris N 《Journal of chemotherapy (Florence, Italy)》2002,14(6):631-634
Intramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic malignancy. Breast cancer is one of the most common solid tumors with a high propensity of CNS dissemination. In the present report we describe two new cases with advanced breast cancer developing ISCM after a variable disease course. One of these patients had brain metastases at presentation, while at relapse developed leptomeningeal carcinomatosis which was treated successfully, but followed shortly, as a terminal event, by ISCM and parenchymal brain recurrence. The other patient was treated initially for locally advanced breast cancer and after multiple locoregional relapses, she developed liver metastases and subsequent ISCM and asymptomatic parenchymal brain deposits. Both patients experienced a rather rapidly evolving disease course leading to death 2 and 4 months, respectively, after widespread neuraxis dissemination of their cancer. Both these cases, added to the list of the anecdotally reported cases of ISCM after breast cancer, undermine the ominous prognosis and limited treatment options available for this disease manifestation, and an extensive literature review and discussion of similar cases is provided. 相似文献
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《Journal of chemotherapy (Florence, Italy)》2013,25(6):631-634
AbstractIntramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic malignancy. Breast cancer is one of the most common solid tumors with a high propensity of CNS dissemination. In the present report we describe two new cases with advanced breast cancer developing ISCM after a variable disease course. One of these patients had brain metastases at presentation, while at relapse developed leptomeningeal carcinomatosis which was treated successfully, but followed shortly, as a terminal event, by ISCM and parenchymal brain recurrence. The other patient was treated initially for locally advanced breast cancer and after multiple locoregional relapses, she developed liver metastases and subsequent ISCM and asymptomatic parenchymal brain deposits. Both patients experienced a rather rapidly evolving disease course leading to death 2 and 4 months, respectively, after widespread neuraxis dissemination of their cancer. Both these cases, added to the list of the anecdotally reported cases of ISCM after breast cancer, undermine the ominous prognosis and limited treatment options available for this disease manifestation, and an extensive literature review and discussion of similar cases is provided. 相似文献
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Potti A Abdel-Raheem M Levitt R Schell DA Mehdi SA 《Lung cancer (Amsterdam, Netherlands)》2001,31(2-3):319-323
Intramedullary spinal cord metastasis (ISCM) is an unusual occurrence in systemic cancer, occurring in as few as 2% of autopsy cases and also represents 8.5% of all cases of central nervous system metastases. Although ISCM from small cell lung carcinoma is well documented, ISCM from non-small cell lung carcinoma of the lung is rarely diagnosed prior to the patients' demise and very little data regarding outcomes exists in such patients. We present the results of our observational case series to better delineate the presentation and clinical course of this uncommon entity which shows that ISCM may present atypically and should be considered in any patient with a previous history of bronchogenic carcinoma and neurologic symptoms. 相似文献
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Gasser T Sandalcioglu IE El Hamalawi B van de Nes JA Stolke D Wiedemayer H 《Journal of neuro-oncology》2005,73(2):163-168
Objective: Intramedullary spinal cord metastases (ISCM) of systemic cancer are rare. To date, patients with ISCM tend to benefit only to a limited extend from surgery and adjuvant therapy. Subject of this investigation is to assess predictive factors for surgical outcome and survival and to evaluate the value of surgical radicality in the treatment of ISCM. Patients and methods: Between 1990 and 2004, a series of 146 patients with intramedullary tumors underwent surgical treatment in our institution. Among these, 13 patients with intramedullary cancer metastases (7 adenocarcinomas, 3 poorly differentiated carcinomas, 3 sarcomas) were identified. Standard microsurgical removal of the ISCM was performed. Functional outcome was graded according to a standardized scale and factors influencing outcome and survival were statistically analyzed. Results: Median progression-free survival was 13 weeks and median overall survival was 31 weeks. In 5 patients (38) the intramedullary lesion was the initial manifestation of the malignant disease. All poorly differentiated carcinomas and all sarcomas were resected incompletely. Surgical radicality presented a negative predictive factor for functional outcome, increasing radicality leading to functional deterioration. Age, sex, tumor localization, surgical radicality and the presence of neoplastic meningeosis did not affect survival. Conclusion: Surgery of ISCM can be performed with an acceptable operative morbidity. Radicality depended on tumor histology. However, radical tumor removal did not affect survival and was correlated with a poor functional outcome. Therefore, complete surgical removal of ISCM should only be intended in patients in whom an unproblematic excision is feasible. 相似文献
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M. Hommadi M. Belemlih E. Marnouch A. Maghous N. Zaghba F.Z. Hamidi A. Bazzine K.A. Saghir M. Elmarjany H. Sifat K. Hadadi H. Mansouri 《Cancer radiothérapie》2021,25(2):169-174
Intramedullary spinal cord metastases (ISCM) is a rare, but devastating complication of malignant disease. Prognosis is poor, with an overall median survival (OS) of 4 months from the time of diagnosis. Yet, ISCMs are being increasingly diagnosed, related to advances and increased use of imaging and therapies that prolong survival in patients with cancer. Prompt and accurate diagnosis of ISCM is necessary for effective treatment, and magnetic resonance imaging (MRI) is the preferred imaging technique. The optimal management of these patients is controversial because of the multitude of clinical circumstances and the lack of controlled studies on the efficacy of the different therapeutic approaches. Increased awareness of this rare entity may lead to an earlier diagnosis at a stage when neurological deficits are reversible, and therefore, more effective palliation may be achieved. Therefore, we carried out this retrospective research of 3 observations of ISCM, associated with a detailed review of the literature describing the diagnostic, therapeutic and evolutionary characteristics of this special rare entity. 相似文献
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Vassilios Vassiliou Dimitrios Papamichael Petros Polyviou Alona Koukouma Dimitrios Andreopoulos 《Journal of gastrointestinal cancer》2012,43(2):370-372
Introduction
Intramedullary spinal cord metastasis (ISCM) is both a rare and devastating event, since it is clinically evident in 0.1–0.9% of cancer patients and the mortality rate at 3–4 months is 80%. 相似文献19.
Intramedullary spinal cord metastasis (ISCM) has been infrequentlydiagnosed during the clinical course of renal cell carcinoma (RCC). With theadvent of more sensitive diagnostic procedures including magnetic resonanceimaging (MRI), more cases of ISCM have been documented. The management ofthese cases is particularly challenging as lack of prompt intervention oftenresults in irreversible progressive neurological deficits. We describe themanagement and clinical course in six patients with RCC who developed ISCM.Two of these patients were treated surgically while four were treated withradiation therapy (RT). Although no major improvements in neurologicalfunction were noted, stabilizations were common. This prolonged their abilityto live independently, a matter of utmost importance in these terminally illpatients. 相似文献