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Updated: Feb 25, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Clinical Outcomes and Prognostic Factors of Stereotactic Radiotherapy for Spinal Metastases With Epidural Spinal Cord
Hongqing Zhuang1,2, Yao Xiao3, Jun Li1
1Department of Radiation Oncology, China-Japan Friendship Hospital, Beijing, China.
Objective:
Investigate the efficacy of stereotactic radiotherapy in patients with metastatic tumors accompanied by epidural spinal cord compression (ESCC) of Grades 1-2 but without vertebral instability who did not undergo surgery.
Methods:
Based on lesion volume and spinal cord compression degree, SBRT doses of 24 Gy/1f, 30 Gy/3f, and 40 Gy/5f were given. The primary endpoint was local progression-free survival (LPFS). Secondary endpoints included toxicity and overall survival (OS). A comparative analysis of LPFS outcomes among different ESCC grades was conducted, and multivariate analysis was used to assess factors influencing local treatment efficacy.
Results:
Among 71 lesions, only three showed local progression. No statistically significant difference in LPFS was observed between ESCC Grades 1 and 2 (p = 0.769). Esophagitis/oral mucositis occurred in 15 cases (33.3%), including 1 case of Grade 3 (2.2%). Nausea occurred in 14 cases (19.7%), with 12 cases of Grade 1 (16.9%) and 2 cases of Grade 2 (2.8%). Vomiting occurred in 3 cases (4.2%), with 2 cases of Grade 1 (2.8%) and 1 case of Grade 2 (1.4%). Acute pain occurred in 3 cases (4.2%). One case (1.4%) had late neurological damage of Grade 2, and there were no cases of spinal cord injury. ESCC grading was not a significant factor affecting LPFS in tumor SBRT (p = 0.693).
Conclusion:
Preliminary findings suggest that for ESCC Grades 1-2 metastatic tumor patients who have no vertebral instability, stereotactic radiotherapy alone has outstanding local control and minimal toxicity. SBRT could be an effective alternative to surgery combined with radiotherapy.
