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Definitive choice Portal 8 cm wide
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səhifə | 17/19 | tarix | 25.12.2016 | ölçüsü | 0,69 Mb. | | #2822 |
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Definitive choice Portal 8 cm wide Extends one to two vertebral bodies above and below the epidural metastasis
Relieves pain in most cases Response most associated with tumor type and radiosensitivity; eg. lymphoma Dosing 20 to 40 Gy in 5 to 20 fractions Popular
Surgery Changing role - No survival benefit with or without radiation15
Better techniques today allow aggressive approach Gross spinal tumor resection with vertebral reconstruction now possible
Recent controlled trial comparing aggressive surgery followed by radiation vs. radiation alone16 Recent controlled trial comparing aggressive surgery followed by radiation vs. radiation alone16 Improvement in surgery+rads - Days remained ambulatory (126 vs. 35)
- Percent that regained ambulation after therapy (56% vs. 19%)
- Days remained continent (142 vs. 12)
- Less steroid dose, less narcotics
- Trend to increase survival
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