Radiation therapy alone provides excellent outcomes for spinal cord compression from vertebral lymphoma

Aim: Malignant spinal cord compression (SCC) is treated with radiotherapy (RT). Additional neurosurgery has become more widely used since a trial showed a benefit for selected patients. Although lymphomas were excluded from that trial, neurosurgery is also increasingly being performed in these patients. This study investigated whether neurosurgery is actually required for this group. Patients and Methods: Twenty-nine patients receiving RT alone for SCC from vertebral lymphoma were analyzed for motor function, walking ability, in-field recurrence and survival. Results: Overall response was 100% (72% improvement, 28% stable). At 1, 6 and 12 months after RT, 83%, 100% and 100% of patients were able to walk; 64%, 100%, and 100% of nonambulatory patients regained their walking ability. Freedom from in-field recurrence was 100% at 6 and 12 months. Survival rates at 6 and 12 months were 79% and 75%. Conclusion: RT alone resulted in excellent outcomes for SCC from lymphoma. These patients may not require surgery.