Radiotherapeutic palliation of spinal epidural compression in small-cell lung cancer

Sixteen patients with spinal epidural compression by metastatic small-cell lung cancer were given radiotherapy for palliation. Lower limb motor deficit was the most prominent clinical manifestation. Neurologic dysfunction was commonly present for more than 48 hours before the diagnosis of compression. Median interval between diagnosis of lung cancer and epidural tumor was 8.5 months. Twelve percent of the patients survived for 1 year after diagnosis of epidural compression. Radiotherapy gave significant pain relief to eight (89%) of the symptomatic individuals. Among those whose status could be assessed, one third of the initially nonambulatory patients (n = 9) were able to walk again. Anal or bladder sphincter or sensory disturbance did not improve in four persons. Radiotherapy for spinal epidural compression in small-cell lung cancer, though not curative, is highly effective in the relief of pain and may ameliorate limb motor dysfunction in some patients.