Epidural compression from metastatic tumor with resultant paralysis

To determine the value of the usually given 'urgent' palliative radiotherapy in paraplegic patients with epidural compression from metastatic tumor, 20 consecutive cases treated between 1981 and 1986 were retrospectively analyzed. Bronchogenic and prostatic carcinoma were the more common extraspinal sources of metastasis. Epidural metastasis involved the thoracic spine in most cases. The onset of neurological symptomatology was frequently within two weeks prior to hospitalization. The majority of the subjects received at least 3000 cGy given in 10 to 15 fractions. Symptomatic (pain relief) response rate was 78 (7/9) percent. The observed period of survival averaged 2.5 months after treatment. This study reaffirmed the little chance for recovery of lost limb(s0 motor function. None of the patients (most of whom were paraplegic from two to 90 days pre-irradiation) became ambulatory including the two in whom irradiation was administered within 24 hours from the onset of paraplegia.