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Cranial nerve deficits in patients with metastatic prostate carcinoma
Clinical features and treatment outcomes
Article first published online: 13 AUG 2004
Copyright © 2004 American Cancer Society
Volume 101, Issue 7, pages 1639–1643, 1 October 2004
How to Cite
McDermott, R. S., Anderson, P. R., Greenberg, R. E., Milestone, B. N. and Hudes, G. R. (2004), Cranial nerve deficits in patients with metastatic prostate carcinoma. Cancer, 101: 1639–1643. doi: 10.1002/cncr.20553
- Issue published online: 17 SEP 2004
- Article first published online: 13 AUG 2004
- Manuscript Accepted: 28 JUN 2004
- Manuscript Revised: 28 MAY 2004
- Manuscript Received: 8 APR 2004
- prostate carcinoma;
- cranial nerve palsy;
- palliative radiation therapy;
- skull base metastasis
Cranial nerve lesions due to metastases from prostate carcinoma to the skull base are an uncommon yet clinically significant finding.
The authors report the clinical features, treatment, and outcomes for 15 patients who presented with cranial nerve palsies complicating metastatic prostate carcinoma. Patient charts identified from a Fox Chase Cancer Center treatment data base were reviewed.
All patients had hormone-refractory disease at the time of symptom onset. Twelve of 15 patients had received prior chemotherapy, and 13 of 15 patients had received prior radiation therapy to areas of bony pain. Symptoms varied from recognized clinical syndromes involving multiple cranial nerves to isolated cranial nerve lesions. All patients had lesions at the skull base that were visualized on computed tomography scans or magnetic resonance images. All patients were treated with palliative radiation therapy to either the whole brain or the skull base. Fourteen of 15 patients had a clinical (either partial or complete) response to radiation therapy. All responding patients subsequently died of prostate carcinoma without worsening of residual or development of new cranial nerve symptoms. Ten of 15 patients (67%) died within 3 months of developing symptoms, and the remaining 5 patients lived between 9 months and 31 months from onset of symptoms.
The authors concluded that palliative radiation therapy should be considered in this heterogeneous group of patients given the potential for significant symptom improvement. Cancer 2004. © 2004 American Cancer Society.