Abstract

Spinal cord compression is a common neurologic complication of advanced cancer, and it is a medical emergency because delay in treatment often results in irreversible paralysis. The treatment-goal of metastatic spinal cord compression is the preservation or restoration of neurologic function. We retrospectively analyzed the results of radiation therapy for metastatic spinal cord compression from January 1987 to May 1992 to assess the neuro1ogic recovery rate of metastatic spinal cord compression by radiation therapy. The results were as follows: ¨cThe most common cause of metastatic spinal cord compression was lung cancer (24%), followed by hepatoma (18%), gastric cancer (8%). ¨e Eighty seven percent of patients presented with localized back pain which preceded diagnosis of spinal cord compression by several weeks. ¨e At diaanosis, 71 % of patients were presented in paralytic status. 27 % of the patients who were ambulatory and 15 % of the paralytic patients before treatment were remained ambulatory or became ambulatory after radiation therapy. ¨eThe duration of survival of all patients were 6 to 159 days (median 55 days). It seemed that the poor outcome of radiation therapy was related to the aggressive biologic features and radioresistance of the primary tumors rather than the neurologic status before the treatment. The prospective study with other treatment modalities such as anterior resection with or without radiation therapy is necessary for improving the neurologic recovery rate.

• Keywords: Spinal cord compression