Spine Stereotactic Body Radiation Therapy for Metastatic Epidural Spinal Cord: Prospective Phase II Study

The definition of metastatic epidural spinal cord compression (MESCC) MESCC is defined as both an evidence of cord compression by radiologic evaluation and a manifestation of clinical feature at the level of cord compression. A cord compression by radiologic evaluation is defined as < 3mm gap between epidural mass and true spinal cord or indentation of thecal sac at the level of clinical feature by MRI. Clinical features include any or all of the followings: pain (local or radicular) or motor weakness or sensory change or incontinence. Simulation -A Computed tomography (CT) scan will be acquired with the use of intravenous contrast and planning MRI will be also performed on the same day of simulation. Spine SBRT - One to four sessions of SBRT will be performed. Follow-up Patients need to be assessed at 1 week, 1 month and 3 months after the completion of SBRT and will be followed up at 3 month intervals thereafter. Pain score, neurologic examination, adverse events and simple X-ray of involved spine should be evaluated at every follow-up visit. MRI of involved spine will be performed at 3 months after the completion of SBRT. Up to 43 patients will be enrolled in this study in Samsung Medical Center, Seoul National University Hospital, and Gachon University Gil Medical Center.