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March 1986

Combination Chemotherapy and Radiation Therapy: The Medical Management of Epidural Spinal Cord Compression From Testicular Cancer

Author Affiliations

From the Division of Hematology/Oncology, University of Alabama at Birmingham and Birmingham Veterans Administration (VA) Medical Center (Dr Friedman); the Division of Medical Oncology (Drs Sheetz and Everett) and the Neuroradiology Department (Dr Levine), Boston VA Medical Center; and the Division of Medicine, M. D. Anderson Hospital and Tumor Institute, Houston (Dr Hong).

Arch Intern Med. 1986;146(3):509-512. doi:10.1001/archinte.1986.00360150119014

• Radiation and surgery are the mainstays of treatment for epidural spinal cord compression. There are reports in the literature, however, in which the use of chemotherapy alone or in combination with radiation and surgery has resulted in improved patient response. We present two patients with spinal cord compression from testicular cancer who developed progressive paraplegias that were successfully reversed with combination chemotherapy, steroids, and radiotherapy. In one case, the patient was unable to receive more than 600 rad (6 Gy) of radiation and his improvement was clearly related to the chemotherapy he received. In treating tumors causing spinal cord compression that are thought to be chemosensitive, one should consider adding chemotherapy to radiation or using chemotherapy alone if the options of surgery or radiation are not available.

(Arch Intern Med 1986;146:509-512)

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