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A prospective study of patients with impending spinal cord compression treated with palliative radiotherapy alone

Published online by Cambridge University Press:  09 May 2013

L. O'Sullivan ,
A. Clayton-Lea ,
O. McArdle ,
M. McGarry ,
J. Kenny ,
M. Dunne ,
E. O'Shea ,
C. Small ,
M. Moriarty  and
P. Thirion
L. O'Sullivan*
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
A. Clayton-Lea
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
O. McArdle
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
M. McGarry
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
J. Kenny
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
M. Dunne
Affiliation:
Clinical Trials Unit, Saint Luke's Radiation Oncology Network, Dublin, Ireland
E. O'Shea
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
C. Small
Affiliation:
Department of Radiation Oncology, Galway University Hospital, Galway, Ireland
M. Moriarty
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
P. Thirion
Affiliation:
Department of Radiation Oncology, Saint Luke's Radiation Oncology Network, Dublin, Ireland
*
Correspondence to: Lydia O'Sullivan, Department of Radiation Oncology, Saint Luke's Radiation Oncology Network at Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. Tel: 353+ 1 704 5577, 353+ 1 852 8625. Fax: 353+ 1 704 5591. E-mail: [email protected]
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Abstract

Impending malignant spinal cord compression (IMSCC) may be defined as compression of the thecal sac, without any visible pressure on the spinal cord itself. Although there is a perception that IMSCC patients have a better prognosis and less severe clinical symptoms than true malignant spinal cord compression (MSCC) patients, these factors have never been documented in the literature.

Purpose

To record the characteristics, management and functional outcome of a group of patients with IMSCC, who were treated with radiotherapy in our institution, and compare these parameters with similar data on MSCC patients.

Materials and methods

Data (gender, age, primary oncological diagnosis, pain, performance status and neurological status) were prospectively collected for 28 patients. Patients were then followed up post treatment to document their response to treatment and treatment-related toxicity.

Results

The median survival of our group of IMSCC patients is similar to that of an MSCC patient. In addition, the IMSCC group exhibits significant clinical symptoms including neurological deficit.

Conclusion

Although further studies are necessary, we have found that IMSCC patients in this study share similar prognosis and clinical symptoms with MSCC patients. Clinicians should be aware of this when communicating with IMSCC patients and their families, and short-course radiotherapy should be considered.

Keywords

impending spinal cord compressionpalliative radiotherapyspinal cord compression
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 12 , Issue 3 , September 2013 , pp. 218 - 225
Copyright
Copyright © Cambridge University Press 2013 

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