Direct Decompressive Surgery with Postoperative Radiation Therapy Helps Spinal Cord Compression Patients Walk Longer, More Often

10/20/2003

From: Beth Bukata, 703-227-0141, Katherine Egan Bennett, 703-227-0156, both of the American Society for Therapeutic Radiology and Oncology

WASHINGTON, Oct. 20 -- Patients with spinal cord compression treated with radical direct decompressive surgery and postoperative radiotherapy retain the ability to walk longer and regain the ability to walk more often than patients treated with radiotherapy alone, according to a study presented October 20, 2003, at the American Society for Therapeutic Radiology and Oncology's 45th Annual Meeting in Salt Lake City.

Patients eligible for this study had a histological diagnosis of cancer with an MRI demonstrating a single site of cord compression. They had to have an expected survival of at least three months and no previous history of radiotherapy to the compression site.

Surgery was performed within 24 hours of study entry with the intent in all cases to remove as much tumor as possible, provide immediate decompression and stabilize the spine. Radiation therapy began within two weeks of surgery in the surgery plus radiotherapy group and within 24 hours of study entry in the radiation therapy only group. Both groups were treated with the same corticosteroid protocol and received equal radiation doses.

One hundred one patients participated in the clinical trial equally divided between the two groups. Sixteen patients in each group entered the study unable to walk. Those in the surgery plus radiotherapy group regained the ability to walk in a significantly greater proportion than patients who received radiotherapy alone. A trend towards longer survival was also in the surgery plus radiation therapy group. "Surgery with radiation therapy permits most patients to remain ambulatory for the remainder of their lives with less steroid and narcotic requirements," said William F. Regine, M.D., Chair of the Department of Radiation Oncology at the University of Maryland School of Medicine in Baltimore and lead author of the study. "Meanwhile, patients treated with radiation therapy alone require more steroid and narcotics and spend approximately two-thirds of their remaining time unable to walk and/or paraplegic. This study has enabled us to show the benefits of adding surgery to radiation therapy and allow patients to retain their ability to walk." If you would like a copy of the abstract entitled, "Metastatic Spinal Cord Compression: A Randomized Trial of Direct Decompressive Surgical Resection Plus Radiotherapy vs. Radiotherapy Alone," or you would like to speak to the lead author of the study, William F. Regine, M.D., please call Beth Bukata after October 18 in the ASTRO Press Room at the Salt Palace Convention Center at 801-534-4743 or e-mail her at bethb@astro.org.

The American Society for Therapeutic Radiology and Oncology is the largest radiation oncology society in the world, with more than 7,000 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society's mission is to advance the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment.