Treatment and final outcome of 11 patients with primary spinal cord ependymomas admitted between 1967 and 1983 have been reviewed. All patients had undergone surgery once or twice before radiation treatment. Six of them are alive and disease-free 78 months to more than 180 months after radiation therapy. A short analysis of the recent literature is presented with special emphasis on the most frequent treatment techniques, extension of radiation fields and doses. The value of postoperative radiation therapy and the complications of both surgery and radiotherapy are analyzed. Some guidelines for treatment are finally discussed and proposed.

No abstract

Spinal cord compression was the presenting symptom in 9 out of 299 previously undiagnosed non-Hodgkin lymphomas observed between 1972 and 1987. All patients had unfavourable histologic diagnosis and 4 had stage I E, 2 stage II E and 2 were staged as IV; one patient did not undergo a staging procedure. All patients were treated with surgery and radiotherapy, whereas chemotherapy was employed in 3 cases only. Only 2 patients are still alive and disease-free after 3 and 8 years respectively; the remaining 7 died with progression of disease, even if in 2 cases a complete clinical remission was obtained. The recent literature has been reviewed. Non-Hodgkin lymphoma with spinal epidural presentation is usually an aggressive disease. An intensive treatment combining surgery, radiotherapy and chemotherapy is finally suggested to achieve better local and long-term results. Surgery can as a rule be limited to laminectomy plus biopsy.

From February 1983 to January 1985, 497 patients with advanced breast cancer were randomly allocated to receive either epirubicin or doxorubicin in the following combination chemotherapy regimen: fluorouracil (5-FU) 500 mg/m2 intravenous (IV) on days 1 and 8; epirubicin or doxorubicin 50 mg/m2 IV on day 1; cyclophosphamide 500 mg/m2 IV on day 1 (FEC or FAC). Cycles were repeated every 21 days until progression or to cumulative doses of 700 mg/m2 for epirubicin and 550 mg/m2 for doxorubicin. Dose reductions were applied according to the standard criteria. Activity was evaluated in 443 patients (222 in the FEC arm and 221 in the FAC arm). The two experimental groups were comparable in age, performance status, menopausal status, histology, previous treatments, and site of the disease. The overall response rate (complete response and partial response [CR + PR]) was not significantly different: 53.6% for FEC and 56.5% for FAC. The median time to progression was 273 days for FEC and 314 days for FAC; the median survival time was 591 and 613 days, respectively. Leukopenia, anemia, nausea, and vomiting were significantly lower in patients treated with FEC. As for cardiotoxicity, four cases of congestive heart failure (CHF) were recorded among patients treated with FAC while only one was observed in the FEC group. These results indicate that epirubicin in a combination chemotherapy regimen is as active as doxorubicin and is significantly less toxic.

No abstract