Citations

Purpose The appropriate treatment for MSCC is controversial. A small randomized trial showed that decompressive surgery followed by radiotherapy was superior to radiotherapy alone. That study was limited to highly selected patients. Additional studies comparing surgery plus radiotherapy to radiotherapy could better clarify the role of surgery. Methods Data from 108 patients receiving surgery plus radiotherapy were matched to 216 patients (1:2) receiving radiotherapy alone. Groups were matched for 11 potential prognostic factors and compared for post-treatment motor function, ambulatory status, regaining ambulatory status, local control, and survival. Subgroup analyses were performed for patients receiving adequate surgery (direct decompressive surgery plus stabilization of involved vertebrae), patients receiving laminectomy, patients with solid tumors, patients with solid tumors receiving adequate surgery, and patients with solid tumors receiving laminectomy. Results Improvement of motor function occurred in 27% of patients after surgery plus radiotherapy and 26% after radiotherapy alone (P = .92). Post-treatment ambulatory rates were 69% after surgery plus radiotherapy and 68% after radiotherapy alone (P = .99). Of the nonambulatory patients, 30% and 26%, respectively, (P = .86) regained ambulatory status after treatment. One-year local control rates were 90% after surgery plus radiotherapy and 91% after radiotherapy alone (P = .48). One-year overall survival rates were 47% and 40%, respectively (P = .50). The subgroup analyses did not show significant differences between both groups. Surgery-related complications occurred in 11% of patients. Conclusion In this study, the outcomes of the end points evaluated after radiotherapy alone appeared similar to those of surgery plus radiotherapy. A new randomized trial comparing both treatments is justified.

Purpose. This study examined whether brief intervention strategies founded on the Behavior-Image Model and addressing positive images of college and career success could be potentially efficacious in impacting multiple health habits of high-risk adolescents transitioning into adulthood. Design. Participants were stratified by grade level and drug use and individually randomized to one of the three Plan for Success interventions, with baseline and 1 month postintervention data collections. Setting. A large, relatively diverse suburban school in northeast Florida. Subjects. A total of 375 11th and 12th grade students participated during the spring semester 2006. Intervention. Three interventions studied included: (1) Goal Survey, (2) Goal Survey plus Contract, or (3) Goal Survey plus Consult. Measures. Outcome measures included multiple health risk, health promotion, and personal development behaviors, as well as image and belief measures. Analysis. Repeated-measures MANOVAs and ANOVAs were used to examine intervention effects. Results. MANOVAs were significant for alcohol use, F (4,328) = 6.33, p = .001; marijuana use, F (4,317) = 3.72, p = .01; exercise, F (3,299) = 4.28, p = .01; college preparation, F (2,327) = 6.26, p = .001; and career preparation, F (2,329) = 6.17, p = .001, with most behaviors improving over time, whereas group-by-time interaction effects were found for nutrition habits, F (6,652) = 2.60, p = .02; and career preparation, F (4,658) = 3.26, p = .01, favoring the consultation. Conclusion. Brief interventions founded on the Behavior-Image Model may have potential to improve selected health and personal development habits among older adolescents.