Intramedullary spinal cord metastasis and radiotherapy

Abstract

Aim: Intramedullary spinal cord metastasis (ISCM) is a rare but a severe condition. We aimed to evaluate the clinical features, the effect of radiotherapy on the functional results, and the quality of life and survival in patients with ISCM. Material andMethods: We retrospectively assessed the results of 15 patients. Patients underwent 3D conformal radiotherapy (3D-CRT). Patients were reviewed in terms of neurological deficits, the localization of primary tumors, the duration of symptoms, onset symptoms, the localization of ISCM,and the interval between diagnosis and spinal metastasis. Post-radiotherapy outcomes and factors influencing the survival and the quality of life were analyzed. Results: The mean duration of symptoms before diagnosis was 14.93 days (range; 1-52 days).The most common presenting symptoms of patients were lower back and back pain. Neurological deficit was present in 9 patients. Of these patients, partial improvement was observed following the radiotherapy in four patients. After the radiotherapy, the need of painkillers and pain were decreased in 10 of the patients with pain at the outset (66.7%). An association was detected between the initiation of radiotherapy within 10 days from the onset of symptoms and the quality of life (p=0.026).The mean survival rate was 5.9 months after being diagnosed with ISCM. Conclusions: Motor deficit and pain-related quality of life were corrupted in most of the patients with ISCM. Early diagnosis and suitable treatment might promote to the functional condition of the patient. It is important to initiate radiotherapy within a period of less than 10 days from the onset of symptoms.