Efficacy and Optimal Condition of Radiotherapy for Metastatic Epidural Cord Compression

Kim, Il Han; Park, Suk Won; Chie, Eui Kyu; Ha, Sung Whan; Park, Charn Il

Abstract

PURPOSE: This study was performed to evaluate the radiotherapy effects on metastatic epidural cord compressions.
MATERIALS AND METHODS
One hundred and thirty eight cases received palliative radio- therapy (30 Gy/10 fractions) with (15) or without (123) surgical decompression. Only 36% of cases were ambulatory before treatment and 34% of cases started treatment within 3 days after symptom onset.
RESULTS
Ambulation was possible after radiotherapy in 38% of all patients and in 73% of cases who was ambulatory before treatment. But the treatment made ambulation possible for 18% of cases who was paraplegic before treatment. Complete response rate, partial response rate, minimal response rate, and progression after treatment were as follows; 7%, 37%, 53%, and 3% respectively for the motor function, 8%, 32%, 58%, and 2% respectively for the sensory function, and 17%, 17%, 65%, and 1% respectively for the autonomic function. Responses were not influenced by the primary tumor site, histology, or involved level of the spine. Good responses were associated with starting treatment within 3 days after symptom onset.
CONCLUSION
Radiotherapy gave optimal palliative effects on metastatic epidural cord compression syndrome. Maximum responses or quality of life could be obtained from prompt treatment with awareness of this syndrome in cancer patients.