Dual Treatment for Spinal Cord Compression

A team of UK researchers has evaluated traditional surgical and radiation therapy options for patients with spinal cord compression due to metastatic cancer and concluded that direct compressive surgery plus postoperative radiotherapy are more effective than either therapy alone or other surgical options.

Metastatic epidural spinal cord compression (MESCC), a common complication of cancer, occurs in 5-14% of cancer patients. Standard treatment consists of corticosteroids and radiotherapy. However, following this therapy, only 50% of patients are able to walk.
Surgery in the form of laminectomy was used before radiotherapy was available but was abandoned after a small trial in 1980 showed no benefit.

A UK research team of Dr. Roy Patchell and colleagues at the University of Kentucky (Lexington, USA) conducted a randomized, multi-institutional, nonblinded trial assessing the efficacy of surgery and radiotherapy combinations in more than 100 patients with spinal cord compression caused by metastatic cancer. The results were so overwhelmingly in favor of the compressive surgery and radiotherapy combination that the study was halted.

These results showed that 84% of patients who received both surgery and radiotherapy were able to walk after treatment, versus only 57% of patients who received only radiation. Moreover, they were able to walk significantly longer and were less dependent on corticosteroids and opiod analgesics. The findings were reported in the August 20, 2005, issue of The Lancet.




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