Always on a Friday: Referral pattern for metastatic spinal cord compression

Abstract

Radiation therapy (RT) for oncologic emergencies is an important aspect of the management of cancer patients. The most common oncologic emergency that may require urgent RT is malignant spinal cord compression (MSCC), occurring in 1–5% of all cancer patients [ 1 Cole J.S. Patchell R.A. Metastatic epidural spinal cord compression. Lancet Neurol. 2008; 7: 459-466 Abstract Full Text Full Text PDF PubMed Scopus (263) Google Scholar , 2 Boogerd W. van der Sande J.J. Diagnosis and treatment of spinal cord compression in malignant disease. Cancer Treat Rev. 1993; 19: 129-150 Abstract Full Text PDF PubMed Scopus (49) Google Scholar ]. Current guidelines in the Netherlands advise an MRI of the entire spinal column within 12 h from the onset of symptoms followed by treatment within 24 h from confirmation of the diagnosis of MSCC. Treatment should comprise immediate administration of corticosteroids (like dexamethasone), followed by either surgery or RT [ 3 Maranzano E. Latini P. Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial. Int J Radiat Oncol Biol Phys. 1995; 32: 959-967 Abstract Full Text PDF PubMed Scopus (394) Google Scholar , 4 Landmann C. Huning R. Gratzl O. The role of laminectomy in the combined treatment of metastatic spinal cord compression. Int J Radiat Oncol Biol Phys. 1992; 24: 627-631 Abstract Full Text PDF PubMed Scopus (54) Google Scholar , 5 Maranzano E. Trippa F. Chirico L. Basagni M.L. Rossi R. Management of metastatic spinal cord compression. Tumori. 2003; 89: 469-475 PubMed Google Scholar , 6 Leviov M. Dale J. Stein M. et al. The management of metastatic spinal cord compression: a radiotherapeutic success ceiling. Int J Radiat Oncol Biol Phys. 1993; 27: 231-234 Abstract Full Text PDF PubMed Scopus (90) Google Scholar ].