Abstract
AbstractIntroduction:Malignant spinal cord compression (MSCC) is a serious condition requiring urgent palliative radiotherapy to alleviate symptoms and avoid permanent paralysis. This audit compares the number of patients treated for MSCC before and during Covid-19, their treatment regimes and 30-day mortality rates to assess if the pandemic affected the treatment and the number of patients referred for palliative radiotherapy.Methods:A retrospective audit was performed (July–December 2019) and 101 patients were treated for MSCC, an average of 17 patients per month. A further audit was undertaken during Covid-19 (March–May 2020) and 36 patients were treated for MSCC, an average of 12 patients per month in this shorter cohort.Results:The results have demonstrated fewer patients presenting during the pandemic and this may be due to patients not wishing to utilise the National Health Service (NHS) during this time. It also highlighted the need to reduce the treatment duration to minimise hospital attendance and lessen the potential for exposure to Covid-19.Conclusion:Educating patients at risk of MSCC is essential and all cancer patients should be counselled on symptoms and what to do if they occur. Ensuring clinicians know the warning signs and the referral pathway for MSCC is also key to ensure early presentation and early referral for treatment.
Highlights
Malignant spinal cord compression (MSCC) is a serious condition requiring urgent palliative radiotherapy to alleviate symptoms and avoid permanent paralysis
A further study was undertaken during Covid-19 (March–May 2020), to analyse if there would be a decrease in the number of patients presenting with MSCC as a result of fewer patients presenting for cancer symptoms and to audit the 30-day mortality rate post-radiotherapy
One limitation of this study was the shorter duration of 3 months during Covid-19 versus the previous 6 months study, as a longer study may have demonstrated less of a decline in patient numbers presenting with MSCC
Summary
Malignant spinal cord compression (MSCC) is a serious condition requiring urgent palliative radiotherapy to alleviate symptoms and avoid permanent paralysis. It is recommended that less than 20% of patients receiving palliative radiotherapy (RT) should die within 30 days of treatment[5] and that appropriate patient selection based on performance status and life expectancy is considered prior to delivery of radiotherapy.
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