Palliative Radiotherapy for Malignant Epidural Spinal Cord Compression

Metastatic epidural spinal cord compression (MESCC) requires urgent multidisciplinary evaluation and intervention in order to maintain or restore neurological functions. Radiotherapy is the most common treatment modality and can effectively palliate pain and maintain neurological functions. Surgical decompression may be appropriate for selected patients with limited metastasis and good prognosis. Mechanical stability of the spine needs to be evaluated concurrently and may require surgery. Pretreatment ambulatory status is a major prognostic factor for ambulatory function after treatment as well as overall survival.