Radiotherapy in the management of metastatic spinal cord compression

ABSTRACT

Presentation and results of metastatic spinal cord compression [MSCC] treated with radiotherapy at Salmaniya Medical Complex [SMC] between July and December 1997 are reported. Out of 96 cancer patients who were treated with radiotherapy, 12 [12.5%] patients had MSCC. This incidence of MSCC was higher than the incidence in the literature. Five patients were ambulatory, three patients had mono/para paresis and four patients had paraplegia berfore the treatment. Radiotherapy dose ranged from 40 Gy in 20 fraction to 20 Gy in 5 fraction. Following radiotherapy patients who presented with mono/paraparesis regained the ambulation and patients who had no neurological signs at presentation maintained ambulation till the last follow up [median 5 months]. Neurological improvement in patients with paraplegia was not enough to make them ambulatory. Compared to earlier reports of MSCC treated with surgery at SMC, there appeared to be an increase in the number of patients with MSCC and its diagnosis at early stage. Radiotherapy was effective in preventing paraplegia in patients with MSCC who were diagnosed and referred early for management. The increase in the number of MSCC as factual or a reference pattern should be assessed in long term analysis: