MALIGNANT SPINAL-CORD COMPRESSION - A PROSPECTIVE EVALUATION

Purpose: To determine the influence of treatment on ambulancy, pain co ntrol and functional outcome of patients with Malignant Spinal Cord Co mpression. Methods and Materials: One hundred and thirty-seven patient s with Malignant Spinal Cord Compression presenting or referred to the Department of Radiation Oncology, Westmead Hospital between August 1, 1989 and August 1, 1990 were studied prospectively. Patients were tre ated with palliative radiation therapy alone, surgery followed by radi otherapy or surgery alone. Two patients were not treated. Post-treatme nt outcome was assessed in terms of ambulatory status, improvement in pain and functional independence using the Functional Independence Mea sure. Results: Thirteen of 16 patients (81%) who were ambulant pre-tre atment remained ambulant after treatment. Two of 16 patients (16.5%) w ho were non-ambulant pre-treatment became ambulant following treatment . Pain improved following treatment in 22 of 30 patients (73%). This b enefit was seen equally for ambulant and non-ambulant patients. A high level of functional independence was maintained in patients who remai ned ambulant. Conclusion: We conclude that prompt treatment of patient s with Malignant Spinal Cord Compression while still able to walk is e ffective in maintaining ambulancy and functional independence, and tha t treatment improves pain in most patients.