Radiotherapeutic management of adult XXXX .

@entity1 @entity424 @entity75 @entity1347 @entity5 @entity1316
Twenty-two adults with @entity424 of the spinal cord were treated with surgery and postoperative radiation between January 1963 and December 1983. The median age was 47 years. Nineteen @entity1 had grade 1 lesions, two had grade 2 and one grade 3. Ten @entity1 had the myxopapillary histologic subtype (all grade 1) and 12 had the cellular variant. There were 15 distal cord lesions originating from the conus medullaris, filum terminale and/or cauda equina. The remaining seven lesions arose more proximally. Fourteen @entity1 had localized lesions involving one to three @entity1347 , while the remaining eight had extensive @entity424 spanning six to thirteen @entity1347 . The median time from onset of symptoms to diagnosis was 3 years. Surgical treatment consisted of biopsy only in three @entity1 , subtotal removal in eleven @entity1 and total removal in eight @entity1 . Radiation was given to the spine only in all cases. Five @entity1 received whole spine radiation; seventeen received partial spine treatment, appropriate for the length of the @entity75 . The median dose was 5000 cGy (range 3600-5700 cGy). The disease free survival at 5 and 10 years was 81 and 71%, respectively. Overall survival at 5 and 10 years was 95%. Seven of twenty-two (32%) @entity1 failed. Factors analyzed for prognostic significance included age, sex, histology, extent of primary, location of primary within the cord, extent of surgical resection and dose. Too few grade 2 and 3 @entity1 precluded meaningful statistical analysis of grade as a prognostic factor. Neither age, sex, histology, extent of primary, location of primary, nor extent of surgical @entity1316 free or overall survival (p greater than 0.05). Four of nineteen (21%) @entity1 with grade 1 lesions failed, while all three @entity1 with grade 2 and 3 lesions did so. Half of the eight @entity1 with extensive @entity424 failed compared to three of fourteen (21%) with limited ones. Six of seventeen (35%) @entity1 failed at doses less than or equal to 5000 cGy while only one of five (20%) failed at doses greater than 5000 cGy. Patterns of failure were analyzed for the seven @entity1 who failed. Six of the seven failures (86% of the failure group, 27% of the overall group) were local, that is, within the initial radiation field at the site of the original @entity5 . A single @entity1 (grade 2) failed in the posterior fossa while remaining NED in the spinal cord (a head CT scan at initial work-up was negative).(ABSTRACT TRUNCATED AT 400 WORDS)
