Stereotactic Radiosurgery in Metastatic Spinal Cord Compression

Inclusion Criteria: * Patients must have histological or cytological confirmed malignancy that is metastatic or unresectable and for which standard curative measures do not exist or are no longer effective * Patients must have localized spine metastasis from first cervical to last lumbar vertebra with evidence of radiological SCC (rSCC) on a diagnostic MRI defined as involvement or compression of either the spinal cord or the cauda equina by an epidural mass lesion or metastatic disease causing impingement, indentation or loss of definition of the thecal sac * A maximum of two separate sites requiring treatment is allowed with maximum two vertebra pr. site * Eligible for surgery defined by technical assessment by surgeon whether surgical decompression is possible with proper stabilization of the spine * No medical co-morbidity contradicting anesthesia * Patient without former treatment for metastatic spinal cord compression with either decompressive surgery and/or radiation therapy * Patient with mild to moderate neurologic signs are eligible. These neurological signs include radiculopathy, dermatomal sensory change, and muscle strength of involved extremity 4/5 on MRC scale * Age ≥18 years * ECOG performance status ≤2 * Life expectancy of greater than 3 months * The effects of ionizing radiation on the developing human fetus are known to be teratogenic. For this reason women of child-bearing potential and men must agree to use adequate contraception prior to study entry and…