Radiotherapy alone for extradural compression by spinal myeloma

Between 1976 and 1992, 18 patients with a histologically proven diagnosis of plasma cell myeloma (PCM) were treated for palliation of spinal extradural compression (EC) by radiotherapy alone. Eighty-five percent of the evaluable symptomatic individuals obtained significant pain relief. Ambulatory ability was retained or regained in 11 (65%) patients. The overall median period of survival was 11 months. Extended median survival was noted in post-treatment ambulatory patients (compared with nonambulatory patients) and in individuals whose primary presentation of PCM was EC (versus individuals who developed EC during the course of the disease). These results suggest that radiotherapy alone may be used in the palliative management of patients with EC by PCM.