PD-7-3 - Clinical Significance of Prophylactic Radiotherapy for Metastatic Spinal Cord Compression

Abstract

The motor function at the beginning of radiotherapy is known to be a functional prognostic factor after radiotherapy for metastatic spinal cord compression (MSCC). Therefore, early diagnosis and treatment are warranted. From this point of view, it may be reasonable for clinicians to consider prophylactic radiotherapy to prevent the development of MSCC.However, there exists little evidence to support the use of prophylactic radiotherapy for asymptomatic patients with spinal metastases but without radiological MSCC. For asymptomatic patients with radiological MSCC (subclinical MSCC), several non-randomized prospective studies have suggested that there is a difference in the incidence rates of symptomatic MSCC between those who receive prophylactic radiotherapy and those who do not.To diagnose patients with radiological MSCC, imaging-based screening plays an important role. MRI is a very sensitive, non-invasive examination for the diagnosis of MSCC. As well as the estimated probability of having radiological MSCC, the cost to the patient and health care system should also be considered to decide on the frequency of MRI screenings. The motor function at the beginning of radiotherapy is known to be a functional prognostic factor after radiotherapy for metastatic spinal cord compression (MSCC). Therefore, early diagnosis and treatment are warranted. From this point of view, it may be reasonable for clinicians to consider prophylactic radiotherapy to prevent the development of MSCC. However, there exists little evidence to support the use of prophylactic radiotherapy for asymptomatic patients with spinal metastases but without radiological MSCC. For asymptomatic patients with radiological MSCC (subclinical MSCC), several non-randomized prospective studies have suggested that there is a difference in the incidence rates of symptomatic MSCC between those who receive prophylactic radiotherapy and those who do not. To diagnose patients with radiological MSCC, imaging-based screening plays an important role. MRI is a very sensitive, non-invasive examination for the diagnosis of MSCC. As well as the estimated probability of having radiological MSCC, the cost to the patient and health care system should also be considered to decide on the frequency of MRI screenings.