Treatment of spinal cord compression from metastatic carcinoma. Review of literature and presentation of a new method of treatment.

Abstract

Nearly 100 articles on the treatment of spinal cord compression from malignant disease are found in the literature. The articles reviewed here represent the largest and the best-documented of those found in the literature. The extreme majority of reports are from the surgical literature yet nearly all successful cases had protracted courses of radiation therapy following their surgical procedures. The literature fails to stress the mortality or mortality of surgical intervention on patients with metastatic carcinoma. The definitions of expediency and immediacy, in terms of spinal cord compression are re-evaluated. The concept of massive-dose rapid radiotherapeutic decompression of the spinal cord is presented. The value of postoperative radiation is substantiated by the surgical literature. An attempt is made to answer the question of “When is pre-irradiation surgery neccessary?”